·临床病例讨论·.20.ChinJOphthalmolandOtorhinolaryngol,April2023,Volume23,Supplement1静脉溶栓治疗视网膜分支动脉阻塞1例△李美丽1秦敬翠2张正培1刘亚鲁1季苏娟1管莉娜1李甦雁1(1.徐州医科大学附属徐州市立医院徐州市第一人民医院眼科徐州市眼病防治研究所徐州221000；2.徐州医科大学附属徐州市立医院徐州市第一人民医院神经内科徐州221000)【摘要】84岁女性，因“右眼突然无痛性视物不见8h”入院。最佳矫正视力(BCVA)：右眼为颞侧手动、鼻侧光感，左眼为0.25；右眼视盘颞上方视网膜可疑轻度灰白色水肿，双眼视网膜动脉血管偏细；光学相干层析成像(OCT)提示右眼黄斑处内层视网膜水肿；彩超提示右眼视网膜中央动脉血流参数较正常下降，双侧颈动脉粥样硬化伴右侧颈动脉斑块形成。入院诊断：右眼视网膜分支动脉阻塞。经过争分夺秒的常规抢救治疗，右眼BCVA仅提高到颞侧眼前指数、鼻侧手动。经过全面评估及有效沟通，请神经内科和介入科会诊，排除禁忌证后，在距离发病15.7h时，予阿替普酶静脉溶栓治疗并密切观察，无颅内出血、胃肠道出血等严重不良反应的发生。治疗效果：溶栓85h后，右眼BCVA提高至1.0-3，随后保持稳定。讨论体会：对视网膜动脉阻塞患者，在全面评估病情、排除禁忌证后，可以考虑多学科联合会诊制订规范的溶栓治疗策略。【关键词】视网膜动脉阻塞；静脉溶栓；多学科会诊AcaseofbranchretinalarteryocclusiontreatedwithintravenousthrombolysisLIMeili1,QINJingcui2,ZHANGZhengpei1,LIUYalu1,JISujuan1,GUANLina1,LISuyan1.1.TheAffiliatedXuzhouMunicipalHospitalofXuzhouMedicalUniversity,DepartmentofOphthalmology,XuzhouFirstPeople’sHospital,EyeDiseasePreventionandTreatmentInstituteofXuzhou,Xuzhou221000,China;2.TheAffiliatedXuzhouMunicipalHospitalofXuzhouMedicalUniversity,DepartmentofNeurology,XuzhouFirstPeople’sHospital,Xuzhou221000,ChinaCorrespondingauthor:LISuyan,Email:lisuyan1226@126.com【Abstract】A84-year-oldfemalepresentedwithsuddenpainlesslossofvisionintherighteyefor8hours.Thebestcorrectedvisualacuity(BCVA)wastemporalhandmovementandnasallightintherighteye,and0.25inthelefteye.Suspectedgray-whitediscolorationoftheretinawasobservedsuperotemporaltotheopticdiscintherighteye,andtheretinalarteryvesselsinbotheyeswerethin.OCToftherightmaculashowedinnerretinale...
