Descemet's membrane injury due to bullet shockwave trauma.
Descemet's membrane injury due to bullet shockwave trauma.
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DOI：
10.1016/j.ajoc.2022.101652
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发表时间：
2022-09
影响因子：
--
通讯作者：
Lee, Hyunjoo J
中科院分区：
文献类型：
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作者：
Swain, David L;Lee, Hyunjoo J
报告一例角膜水肿合并下膜（DM）损伤，可能是由于子弹穿过眼睛造成的冲击波创伤所致。一名27岁的男子因左眼疼痛、发红和视力严重下降而被送往急诊室。眼部检查发现颞结膜撕裂、角膜水肿、前房积血及玻璃体出血。在病人的左胸部和腋窝发现了子弹，鼻梁上有撕裂伤，但在眼睛内或周围没有发现异物。眼内出血和角膜水肿逐渐消退，可见DM不规则，可能为微破裂。7个月后，未矫正视力改善至20/25，角膜无水肿，但有持续的小局灶性DM增厚和瘢痕。该病例说明高速抛射物的冲击波损伤可导致糖尿病和内皮细胞损伤。在我们的病例中，假定是小的中枢性糖尿病微破裂，经过局部治疗和观察，角膜水肿消退，视力明显改善，表明这类损伤的总体预后良好。
To report a case of corneal edema associated with Descemet membrane (DM) damage likely due to shockwave trauma from a bullet passing by the eye. A 27-year-old man presented to the emergency department with pain, redness, and severely decreased vision in the left eye immediately following a gun assault. Examination of the eye revealed a temporal conjunctival laceration, corneal edema, hyphema, and vitreous hemorrhage. Bullets were found in the patient's left chest and axilla, and a laceration was present on the bridge of his nose, but no foreign bodies were found in or around the eyes. The intraocular hemorrhage and corneal edema gradually resolved, and it became apparent that there were DM irregularities that possibly represented micro-ruptures. After 7 months, uncorrected visual acuity improved to 20/25, and the cornea was free of edema but had persistent small focal areas of DM thickening and scarring. This case illustrates that DM and possibly endothelial cell damage can occur due to shockwave injury from high-speed projectiles. In our case of presumed small central DM micro-ruptures, the corneal edema resolved, and the vision significantly improved with topical therapy and observation, suggesting an overall good prognosis from such injuries.