The choroidal structure changes in a case with hypertensive choroidopathy
The choroidal structure changes in a case with hypertensive choroidopathy
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高血压脉络膜病变一例脉络膜结构改变
DOI：
10.1016/j.ajoc.2020.100710
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Makoto Nakamura
中科院分区：
文献类型：
--
作者：
Daiki Sakai;Wataru Matsumiya;Sentaro Kusuhara;Makoto Nakamura
本研究的目的是报告一位27岁女性，诊断为妊娠期高血压疾病（HDP）并发弥散性血管内凝血（DIC），她的右眼出现色觉异常和视物变形，在紧急剖腹产后的半天。眼底检查显示右眼从上级半球至后极部有浆液性视网膜脱离。然后，荧光素血管造影（FA）显示右眼视盘上方区域和左眼视盘周围区域有一些颗粒状渗漏。吲哚菁绿色血管造影（IA）也显示在FA中相同渗漏区域的早期阶段脉络膜灌注不足和中期阶段脉络膜通透性过高。SD-OCT还显示右眼后部SRD和左眼乳头周围平坦SRD，增强深度成像OCT（EDI-OCT）显示脉络膜厚度增加。在观察期间，SRD逐渐消失，患者的症状得到改善，并接受了适当的高血压治疗和DIC消退。此外，增加脉络膜厚度在右眼改善的唯一领域显示异常的血管造影结果，但在双眼中心凹下脉络膜厚度并没有改变在临床course.ConclusionsOur的情况下表明，高血压性脉络膜病变与发展中的SRD和视觉障碍的患者HDP，可以改善通过适当的治疗一般状态。此外，SD-OCT显示了一个新的发现，即在SRD完全消失之前，异常血管造影区域的脉络膜厚度增加得到改善。OCT可以作为一个有用的模块来评估脉络膜结构的变化，以诊断和随访高血压性脉络膜病变患者。
PurposeThe aim of this study is to report clinical course and provide novel ophthalmic findings by spectral-domain optical coherence tomography (SD-OCT) in a patient with hypertensive choroidopathy secondary to hypertensive disorders of pregnancy (HDP).ObservationsA 27-year-old woman, who was diagnosed HDP complicated with disseminated intravascular coagulation (DIC), noticed abnormality of color vision and metamorphopsia in her right eye, a half day after an emergency cesarean delivery. Fundus examinations showed developing serous retinal detachment (SRD) from superior hemisphere to the posterior pole in her right eye. Then, fluorescein angiography (FA) showed some granular leakages from the areas above the optic disc in her right eye and around the optic disc in her left eye. Indocyanine green angiography (IA) also showed choroidal hypoperfusion during the early-phase and choroidal hyperpermeability during the mid-phase in the same areas of leakages in FA. SD-OCT also showed posterior SRD in her right eye and peripapillary flat SRD in her left eye, and enhanced depth imaging OCT (EDI-OCT) revealed increased choroidal thickness. SRD gradually disappeared and her symptoms improved during observation with appropriate treatment for hypertension and resolution of DIC. Moreover, increased choroidal thickness in right eye improved in the only areas showing abnormal angiography findings, but subfoveal choroidal thickness in both eyes did not change over the clinical course.ConclusionsOur case shows that hypertensive choroidopathy with developing SRD and visual disorder in the patient with HDP, can be improved by appropriate treatment for general state. Moreover, SD-OCT shows a new finding that increased choroidal thickness improved in the abnormal angiography areas earlier than SRD was completely disappeared. OCT may be a useful module to evaluate the changes in the choroidal structures for diagnosis and follow-up in a patient with hypertensive choroidopathy.
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影响因子：
--
作者：
D. Cogan
通讯作者：
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影响因子：
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期刊：
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DOI：
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发表时间：
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期刊：
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影响因子：
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