鼻咽癌长期放射治疗后双眼缺血综合征1例

摘要

目的 报道1例因接受放射治疗后出现双侧颈总动脉完全闭塞和双眼缺血综合征(ocular ischemic syndrome,OIS)的患者.方法 病例报告.1例57岁男性患者主诉左眼一过性黑矇伴有眼部和眶周疼痛6mo,诊断为双侧OIS,依次给予双侧全视网膜光凝(panretinal photocoagulation,PRP)、白内障手术、颈动脉内膜剥脱术和Ahmed青光眼阀植入术.结果 经过PRP和白内障超声乳化手术治疗,双侧眼部病情稳定.但患者行双侧颈动脉内膜剥脱术后出现眼压升高,视力降至指数.结论 鼻咽癌放射治疗后出现的双侧颈总动脉完全闭塞和双眼OIS的治疗比较困难,预后不佳.%AIM: To report a case of bilateral ocular ischemic syndrome(OIS) with bilateral common carotid artery complete occlusion in a patient after long-term radiotherapy for nasopharyngeal carcinoma.METHODS: Interventional case report. A 57-year-old man presented with a 6-month history of amaurosis fugax in his left eye and ocular and periorbital pain, diagnosed with bilateral OIS. Bilateral panretinal photocoagulation (PRP),cataract surgery, carotid endarterectomy and an Ahmed valve implant were performed consecutively.RESULTS: After PRP and uneventful cataract phacoe- mulsification administrated, the conditions of bilateral eyes were stabilized. However after bilateral carotid endarterectomy, the intraocular pressure(IOP) was increased,accompanied by the visual acuity reduced to counting fingers at six inches.CONCLUSION: The management of bilateral OIS with bilateral common carotid arteries complete occlusion after long-term radiotherapy for nasopharyngeal carcinoma is frustrating and the prognosis for vision is poor.