硅油填塞致视网膜血管闭塞术后中毒性后段综合征1例

Q3 Medicine

American Journal of Ophthalmology Case Reports Pub Date : 2025-07-28 DOI:10.1016/j.ajoc.2025.102404

Miho Kumoi, Satoshi Matsuda, Mai Matsumoto, Chieko Tsujino, Yasumasa Otori

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引用次数: 0

摘要

目的报告一例罕见的术后硅油致视网膜血管闭塞的病例。观察1例男性患者，71岁，视力下降，诊断为黄斑孔性视网膜脱离（MHRD）。患者行玻璃体切除（PPV）并注射硅油。术后一天，虽然前房炎症和充血轻微，但眼底检查显示视网膜血管闭塞。假定患者患有细菌性眼内炎并再次接受PPV治疗，其中硅油被移除，随后给予抗生素和类固醇滴眼液。术后2周炎症改善；患者接受了第二次MHRD手术，并注射了硅油。然而，术后第二天观察到相同的血管闭塞现象。血管闭塞被认为是由于无菌炎症而不是细菌性眼内炎；硅油去除后炎症症状消退。结论硅油注射后早期发生视网膜血管闭塞，若前段炎症较轻，应考虑后段中毒性综合征的可能性。

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Toxic posterior segment syndrome caused by silicone oil tamponade resulting in postsurgical retinal vascular occlusion: a case report

Purpose

We aimed to report a rare case of postoperative retinal vessel occlusion caused by silicone oil.

Observations

A 71-year-old male patient presented with decreased visual acuity and was diagnosed with macular hole retinal detachment (MHRD). The patient underwent pars plana vitrectomy (PPV) and was administered a silicone oil injection. The day after surgery, although inflammation and hyperemia within the anterior chamber were mild, fundus examination revealed evidence of retinal blood vessel occlusion. The patient was assumed to have contracted bacterial endophthalmitis and underwent PPV again, wherein the silicone oil was removed followed by antibiotic administration and steroid eye drops initiation. The inflammation improved 2 weeks after surgery; the patient underwent a second operation for MHRD and was administered a silicone oil injection. However, the same vascular occlusion findings were observed the day after surgery. Vascular occlusion was thought to be due to sterile inflammation rather than bacterial endophthalmitis; the inflammatory findings subsided after silicone oil removal.

Conclusions

In cases of retinal vascular occlusion occurring early after silicone oil injection, if the anterior segment inflammation is mild, the possibility of toxic posterior segment syndrome must be considered.

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来源期刊

American Journal of Ophthalmology Case Reports Medicine-Ophthalmology

CiteScore

2.40

自引率

0.00%

发文量

513

审稿时长

16 weeks

期刊介绍： The American Journal of Ophthalmology Case Reports is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished case report manuscripts directed to ophthalmologists and visual science specialists. The cases shall be challenging and stimulating but shall also be presented in an educational format to engage the readers as if they are working alongside with the caring clinician scientists to manage the patients. Submissions shall be clear, concise, and well-documented reports. Brief reports and case series submissions on specific themes are also very welcome.