PRP眼周注射致失明.docx

Irreversible Blindness Following Periocular Autologous Platelet-Rich Plasma Skin Rejuvenation Treatment眼周富血小板血浆注射用于皮肤年轻化治疗导致永久性失明的案例分析Krishnapriya Kalyam, M.D., Shaheen C. Kavoussi, M.D., Michael Ehrlich, M.D., Christopher C. Teng, M.D., Nisha Chadha, M.D., Sarah Khodadadeh, M.D., and Ji Liu, M.D. Abstract: 摘要： A 49-year-old woman developed acute visual loss in the right eye following bilateral cosmetic platelet-rich plasma injections to rhytids in the glabellar region. External exam showed skin necrosis in the region over the right rhytids and restricted right ocular motility. Dilated fundus exam was significant for ophthalmic artery occlusion. Imaging revealed right eye extraocular muscle ischemia and optic nerve infarction, along with right frontal, parietal, and occipital lobe infarction. Work-up for thromboembolic and vascular etiologies were negative. To our knowledge, this is the first case reported of extensive ischemia following autologous platelet-rich plasma therapy. 一位49岁的女性在双侧眉间褶皱区域注射了富含血小板血浆后出现急性的右眼视力丧失，外部检查发现右侧褶皱区域上方出现皮肤坏死、右眼球运动受限。眼底检查显示重要的眼动脉发生栓塞。成像显示右眼眼外肌缺血和视神经梗死，右额叶、顶叶和枕叶梗死。血栓形成和血管方面的病因检查是阴性的。据我们所知，这是第一例被报道的因自体富含血小板血浆治疗而导致广泛缺血的病例。CASE REPORT病例报告The case reported here is in compliance with the Health Insurance Portability and Accountability Act (HIPAA) regulation. An otherwise healthy 49-year-old woman presented to the Yale Eye Center complaining of acute loss of vision in the right eye associated with severe nausea and eye pain. One day prior, the patient underwent an autologous platelet-rich plasma (APRP) injection procedure by an unlicensed practitioner to reduce wrinkles in the glabellar region bilaterally. She reported that blood was taken from her antecubital region by venous puncture and centrifuged to obtain concentrated autologous plasma. Bilateral forehead rhytids injections were performed. The patient was unaware the details of the plasma preparation and the size of needle that was used for injecti