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NEJM：瞳孔残膜-案例报道

2017-02-12 xing.T MedSci原创

瞳孔残膜视力下降
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这些膜代表了晶状体血管膜的残余，这是结构对发育中的胎儿晶状体进行血液供应。毛细血管的残余可能仍存在并卷缩成小股附着于虹膜上。视觉通常是不受影响，但偶尔有些患者的会增厚，瞳孔残膜可引起剥夺性弱视（即由于光线媒介的不透明引起视网膜刺激剥夺，导致的弱视），它可以用散瞳剂、成功的手术切除或激光裂解进行治疗。

患者为一名15岁的男孩，因双眼视力下降而就诊。通过Snellen视力表检测该患者的矫正视力右眼为20/20，左眼为20/60，并且左眼存在弱视。


常规裂隙灯检查发现了该患者双眼存在瞳孔残膜的证据（图A显示为右眼和图B为左眼）。

这些膜代表了晶状体血管膜的残余，这是结构对发育中的胎儿晶状体进行血液供应。毛细血管的残余可能仍存在并卷缩成小股附着于虹膜上。视觉通常是不受影响，但偶尔有些患者的会增厚，瞳孔残膜可引起剥夺性弱视（即由于光线媒介的不透明引起视网膜刺激剥夺，导致的弱视），它可以用散瞳剂、成功的手术切除或激光裂解进行治疗。

这个患者右眼每天用几小时的贴片进行治疗。在就诊后随访3个月，该患者的左眼视力提高到了20/40。

原始出处：

Varada Gokhale, et al. Persistent Pupillary Membrane. N Engl J Med 2017; 376:561February 9, 2017.DOI: 10.1056/NEJMicm1507964

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  1. [GetPortalCommentsPageByObjectIdResponse(id=301263, encodeId=f7e83012635d, content=这里面说的贴片指的什么贴片呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=accd2313749, createdName=12231652m65暂无昵称, createdTime=Fri Mar 30 20:38:13 CST 2018, time=2018-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393215, encodeId=3c971393215c2, content=<a href='/topic/show?id=34aae3121a7' target=_blank style='color:#2F92EE;'>#瞳孔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73121, encryptionId=34aae3121a7, topicName=瞳孔)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIpeueeYB1kem1yfEZrSYKBdZBoqac9USf0RxIgRICBIyDn4licyiaiakNnobeCDVpvwqaWgwTNeLRHA/132, createdBy=bb5e2500127, createdName=小几洁, createdTime=Tue Feb 14 02:57:00 CST 2017, time=2017-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=175780, encodeId=d8851e578042, content=非常好的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun Feb 12 16:18:42 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=175749, encodeId=dff21e5749a6, content=先天性瞳孔残膜、瞳孔膜闭，虹膜前隆、, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuF63NQckT5BOaic1el7cRelbpr859YXtZQHQSaWnqZCRPOZzDBcjsBNx7AFefLHh1UvMPS4kPP0BG/0, createdBy=47831990981, createdName=1e1a50a1m36(暂无匿称), createdTime=Sun Feb 12 12:33:51 CST 2017, time=2017-02-12, status=1, ipAttribution=)]
    2018-03-30 12231652m65暂无昵称

    这里面说的贴片指的什么贴片呢?

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=301263, encodeId=f7e83012635d, content=这里面说的贴片指的什么贴片呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=accd2313749, createdName=12231652m65暂无昵称, createdTime=Fri Mar 30 20:38:13 CST 2018, time=2018-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393215, encodeId=3c971393215c2, content=<a href='/topic/show?id=34aae3121a7' target=_blank style='color:#2F92EE;'>#瞳孔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73121, encryptionId=34aae3121a7, topicName=瞳孔)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIpeueeYB1kem1yfEZrSYKBdZBoqac9USf0RxIgRICBIyDn4licyiaiakNnobeCDVpvwqaWgwTNeLRHA/132, createdBy=bb5e2500127, createdName=小几洁, createdTime=Tue Feb 14 02:57:00 CST 2017, time=2017-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=175780, encodeId=d8851e578042, content=非常好的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun Feb 12 16:18:42 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=175749, encodeId=dff21e5749a6, content=先天性瞳孔残膜、瞳孔膜闭，虹膜前隆、, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuF63NQckT5BOaic1el7cRelbpr859YXtZQHQSaWnqZCRPOZzDBcjsBNx7AFefLHh1UvMPS4kPP0BG/0, createdBy=47831990981, createdName=1e1a50a1m36(暂无匿称), createdTime=Sun Feb 12 12:33:51 CST 2017, time=2017-02-12, status=1, ipAttribution=)]
    2017-02-14 小几洁

    #瞳孔#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=301263, encodeId=f7e83012635d, content=这里面说的贴片指的什么贴片呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=accd2313749, createdName=12231652m65暂无昵称, createdTime=Fri Mar 30 20:38:13 CST 2018, time=2018-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393215, encodeId=3c971393215c2, content=<a href='/topic/show?id=34aae3121a7' target=_blank style='color:#2F92EE;'>#瞳孔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73121, encryptionId=34aae3121a7, topicName=瞳孔)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIpeueeYB1kem1yfEZrSYKBdZBoqac9USf0RxIgRICBIyDn4licyiaiakNnobeCDVpvwqaWgwTNeLRHA/132, createdBy=bb5e2500127, createdName=小几洁, createdTime=Tue Feb 14 02:57:00 CST 2017, time=2017-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=175780, encodeId=d8851e578042, content=非常好的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun Feb 12 16:18:42 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=175749, encodeId=dff21e5749a6, content=先天性瞳孔残膜、瞳孔膜闭，虹膜前隆、, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuF63NQckT5BOaic1el7cRelbpr859YXtZQHQSaWnqZCRPOZzDBcjsBNx7AFefLHh1UvMPS4kPP0BG/0, createdBy=47831990981, createdName=1e1a50a1m36(暂无匿称), createdTime=Sun Feb 12 12:33:51 CST 2017, time=2017-02-12, status=1, ipAttribution=)]
    2017-02-12 天涯183

    非常好的文章

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=301263, encodeId=f7e83012635d, content=这里面说的贴片指的什么贴片呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=accd2313749, createdName=12231652m65暂无昵称, createdTime=Fri Mar 30 20:38:13 CST 2018, time=2018-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393215, encodeId=3c971393215c2, content=<a href='/topic/show?id=34aae3121a7' target=_blank style='color:#2F92EE;'>#瞳孔#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73121, encryptionId=34aae3121a7, topicName=瞳孔)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIpeueeYB1kem1yfEZrSYKBdZBoqac9USf0RxIgRICBIyDn4licyiaiakNnobeCDVpvwqaWgwTNeLRHA/132, createdBy=bb5e2500127, createdName=小几洁, createdTime=Tue Feb 14 02:57:00 CST 2017, time=2017-02-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=175780, encodeId=d8851e578042, content=非常好的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun Feb 12 16:18:42 CST 2017, time=2017-02-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=175749, encodeId=dff21e5749a6, content=先天性瞳孔残膜、瞳孔膜闭，虹膜前隆、, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuF63NQckT5BOaic1el7cRelbpr859YXtZQHQSaWnqZCRPOZzDBcjsBNx7AFefLHh1UvMPS4kPP0BG/0, createdBy=47831990981, createdName=1e1a50a1m36(暂无匿称), createdTime=Sun Feb 12 12:33:51 CST 2017, time=2017-02-12, status=1, ipAttribution=)]
    2017-02-12 1e1a50a1m36(暂无匿称)

    先天性瞳孔残膜、瞳孔膜闭，虹膜前隆、

    0

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