对视网膜病变相关自身免疫性溶血性贫血疗效显著

Rofa Husnul Khuluqi, N. Dewi, Susanto Nugroho, Lely Retno Wulandari
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摘要

介绍自身免疫性溶血性贫血(AIHA)视网膜病变的临床表现及其在类固醇治疗后的快速解决方案。病例报告:一名14岁的女性患者表现为左眼视力下降。有AIHA的历史。LE视力为1/60,RE视力为6/6,结膜苍白,其他前段无明显变化。左眼眼底检查发现火焰状及点状出血,罗氏斑,视盘肿胀,静脉曲张,黄斑升高。传入瞳孔缺损,红绿缺乏,对比敏感度下降。血液学检查显示贫血。头部及眼眶MRI检查无明显异常。讨论:该患者被评估为AIHA所致LE贫血性视网膜病变。口服类固醇治疗1个月后,视网膜病变消退,患者视力改善。结论:贫血可能与视网膜病变的发生有关。视网膜病变的诊断可以通过将眼科检查结果与阳性血清学试验联系起来进行。准确全面的检查可建立全身性诊断,控制全身性参数可改善视网膜病变,逆转视力下降,避免永久性失明
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REMARKABLE RESULT TOWARDS RETINOPATHY ASSOCIATED AUTOIMMUNE HEMOLYTIC ANEMIA
Introduction: To present the clinical findings of Autoimmune hemolytic anemia (AIHA) Retinopathy and its rapid resolutions following treatment with steroid. Case report: A 14-year-old female patient presented with decreased vision in the left eye. There was history of AIHA. Visual acuity was 1/60 in LE and 6/6 in RE. There was conjunctival pallor, and the other anterior segment were unremarkable. Fundus examination of left eye revealed flame shaped and dot blot hemorrhage, roth’s spots, optic disc swelling, venous turtuosity, and elevated macula. There were afferent pupil defect, red green deficiency, and contrast sensitivity decline. Hematological evaluation revealed anemia. A MRI Head and Orbital examination were unremarkable. Discussion: This patient was assessed with LE Anemic retinopathy due to AIHA. The patient’s visual acuity improved as the retinopathy resolved after 1 month of oral steroid therapy. Conclusion: Anemia may play a role in the occurrence of retinopathy. The diagnosis of retinopathy can be made by linking ophthalmic fndings with positive serological test. Accurate comprehensive examination can establish the systemic diagnosis, and control of systemic parameters will improve retinopathy, reverse vision loss, and avoid permanent blindness
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