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Tytuł:
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A Case of Idiopathic Dense Vitreous Hemorrhage: Suspected Rupture of a Large Retinal Arterial Macroaneurysm on the Optic Disc.
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Autorzy:
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Takahashi S; Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
Nishida K; Advanced Visual Neuroscience, Osaka University Graduate School of Medicine, Osaka, Japan.
Sakaguchi H; Department of Advanced Device Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
Nishida K; Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.; Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives (OTRI), Osaka University, Osaka, Japan.
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Źródło:
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Case reports in ophthalmology [Case Rep Ophthalmol] 2021 Jul 16; Vol. 12 (2), pp. 634-639. Date of Electronic Publication: 2021 Jul 16 (Print Publication: 2021).
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Typ publikacji:
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Case Reports
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Język:
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English
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Imprint Name(s):
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Original Publication: Basel : Karger AG
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References:
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Contributed Indexing:
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Keywords: Hematoma; Optic disc; Retinal arterial macroaneurysm; Vitreous hemorrhage
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Entry Date(s):
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Date Created: 20210820 Latest Revision: 20210821
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Update Code:
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20240104
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PubMed Central ID:
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PMC8339441
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DOI:
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10.1159/000511110
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PMID:
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34413754
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We report a novel case of vitreous hemorrhage associated with suspected rupture of 2-disc-diameter retinal arterial macroaneurysm on the optic disc. A 90-year-old woman presented with blurred vision (sudden onset) in her left eye. Examination of the fundus revealed acute onset vitreous hemorrhage of unknown origin without retinal detachment. She underwent vitrectomy, but after excision of the dense vitreous hemorrhage, a 2-disc-diameter hematoma appeared on the optic disc and was removed promptly. Because the bleeding at the base of the hematoma was of arterial origin and pulsating, the first vitrectomy could not achieve hemostasis. Five days after the first surgery, we performed a second vitrectomy. This revealed a subretinal hemorrhage along the superior and inferior arcade vessels and a macular hole, which was almost completely closed with an inverted internal limiting membrane flap. Unfortunately, the macular hole reopened 41 days after the second surgery. In patients presenting with only a large hematoma on the optic disc, it might be prudent to leave the hematoma. However, this large retinal arterial macroaneurysm was on a rare location on the optic disc, making it doubly difficult for the surgeons to diagnose and choose the best option intraoperatively. The differential diagnosis for dense vitreous hemorrhage of unknown origin should include a large retinal arterial macroaneurysm on the optic disc.
Competing Interests: The authors have no conflicts of interest to disclose.
(Copyright © 2021 by S. Karger AG, Basel.)
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