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1 病例报告 患者男,58岁,因右眼突然视物不清,伴下方视野缺损25天就诊。曾在当地医院予青、链霉素等治疗,未奏效。门诊以“急性缺血性视乳头病变”收住院。原有高血压病史13年。否认糖尿病。查体:T36.3℃,R20次/分,P80次/分,BP26/18kPa,全身检查未见异常。眼科情况:视力右4.1,不能矫正,左5.0,双外眼正常,晶体尚透明。眼底检查,见右眼视乳头隆起边界不清,约2.0屈光度,其边有梭条状出血,视网膜动脉管壁反光增强,动静脉交叉压迫征明显。静脉迂曲,黄斑区有星芒状渗出,左眼视网膜动脉反光强,静脉迂曲,未见渗出及出血。眼压正常,视野:右眼下方缺损。实验室检查:尿糖(+++),血糖17.8mmol/L。
A case report Male patient, 58 years old, because the right eye suddenly blurred vision, with visual field defects below 25 days treatment. Had in the local hospital to green, streptomycin and other treatment, did not work. Clinic to “acute ischemic optic disc lesions” admitted to hospital. The original history of hypertension for 13 years. Denied diabetes. Physical examination: T36.3 ℃, R20 beats / min, P80 beats / min, BP26 / 18kPa, no abnormalities in the whole body examination. Ophthalmology: Visual right 4.1, can not be corrected, left 5.0, the two outer eyes normal, the crystal is transparent. Fundus examination, see the vision of the right eye uplift unclear boundary, about 2.0 diopter, the side of a shuttle strip of blood, retinal artery wall reflex enhanced, arteriovenous cross compression sign significantly. Venous tortuosity, astragalus-like macular exudate, left eye retinal artery reflex, venous tortuosity, no exudation and bleeding. Intraocular pressure normal, vision: right eye defect below. Laboratory tests: urine (+++), blood glucose 17.8mmol / L.