Trudności terapeutyczne w leczeniu idiopatycznego krwotoku przedsiatkówkowego – opis przypadku
Therapeutic Difficulties in Idiopathic Preretinal Hemorrhage – Case Report
Anna Karasińska, Patrycja Krzyżanowska-Berkowska, Bartłomiej Markuszewski, Marek Szaliński, Marta Misiuk-Hojło, Radosław Kaczmarek
Katedra i Klinika Okulistyki Uniwersytetu Medycznego we Wrocławiu
Kierownik: prof. dr hab. n. med. Marta Misiuk-Hojło
Summary: Purpose: We report therapeutic difficulties associated with ophthalmic case of the idiopathic preretinal hemorrhage localized in subhyaloidal space between internal limiting membrane and posterior vitreal surface. Therapeutic possibilities depend on time period elapsed since hemorrhage appearance, the cause of hemorrhage, location and its size.
Case presentation: Forty-one years old female patient was admitted to Emergency Department of the Ophthalmology Clinic of Wroclaw Medical University with sudden vision loss in the left eye. Patient presented no medical history of chronic diseases or trauma. The visual acuity was counting fingers in the left eye. Preretinal hemorrhage was diagnosed and therapy with laser treatment was performed. Due to ineffective laser treatment, partial evacuation of hemorrhage to the vitreous cavity and persistent low vision it was decided to perform pars plana vitrectomy.
Results: As a result of vitrectomy full evacuation of hemorrhage was achieved, however 8 months after surgery, dense, posterior pole cataract was noticed and phacoemulsification with posterior-chamber intraocular lens implantation was performed. Final visual acuity at 8 months following surgery with refractive correction of -0.75 Dcyl ax 1250 was 1.0 using Snellen chart.
Conclusions:Due to lack of one standard treatment algorhithm in preretinal hemorrhages, laser therapy is the therapy of choice to evacuate hemorrhage into vitreous cavity. If no desired effect is achieved pars plana vitrectomy should be performed. The time period elapsing is crucial for the final visual acuity.
Słowa kluczowe: idiopatyczny krwotok przedsiatkówkowy, terapia laserowa, pars plana witrektomia.
Keywords: idiopathic preretinal hemorrhage, laser treatment, pars plana vitrectomy.