视网膜淋巴瘤治疗中视网膜动脉阻塞1例并文献复习

Retinal artery occlusion during treatment of primary vitreoretinal lymphoma:a case report and literature review

目的 报道1例玻璃体视网膜淋巴瘤治疗过程中出现视网膜动脉阻塞病例的临床特征及治疗要点,分析其形成的相关原因。方法 回顾该病例的诊断和治疗过程,结合病例资料及相关文献进行分析讨论。结果 入院后根据病史、症状及体征,行眼内液细胞因子检测及基因重排,诊断为“玻璃体视网膜淋巴瘤”。给予多次玻璃体腔注射甲氨蝶呤治疗,定期复查,拟行再次玻璃体腔注射前,出现视网膜动脉阻塞。结论 玻璃体视网膜淋巴瘤的诊断具有挑战性,因其临床症状可以模仿其他眼部疾病,在治疗过程中,需要关注眼部及全身系统情况,提高患者生活质量及生存时间。

Objective This study reports the clinical features and treatment of a case of retinal artery occlusion during vitreoretinal lymphoma treatment.We also analyze and describe the relevant reasons for retinal artery occlusion formation.Methods The diagnosis and treatment of the case were reviewed.The case data and related literature were analyzed and discussed.Results After admission,according to the medical history,symptoms,and signs,cytokines in intraocular fluids and gene rearrangement were detected and a diagnosis of"vitreoretinal lymphoma"was established.Methotrexate intravitreal injection and regular follow-up were performed.However,retinal artery occlusion occurred before another planned intravitreal injection.Conclusion Vitreoretinal lymphoma diagnosis is challenging because its clinical symptoms could mimic other eye diseases.In the treatment course,attention should be paid to the eye and systemic system to improve patients'quality of life and survival time.