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结节病性葡萄膜炎患者增殖膜的组织病理学发现。

Histopathological findings in proliferative membrane from a patient with sarcoid uveitis.

作者信息

Miyao A, Ikeda T, Matsumoto Y, Uchida K, Machida T, Hongo M, Kinoshita S

机构信息

Department of Ophthalmology, Nishijin Hospital, Kyoto, Japan.

出版信息

Jpn J Ophthalmol. 1999 May-Jun;43(3):209-12. doi: 10.1016/s0021-5155(99)00003-9.

Abstract

BACKGROUND

Sarcoid uveitis is occasionally accompanied by proliferative changes, such as retinal neovascularization and vitreous hemorrhage. Steroid administration, retinal photocoagulation, and vitrectomy may be indicated in such proliferative cases.

CASE

A 19-year-old woman presented with proliferative sarcoid uveitis accompanied by recurrent vitreous hemorrhage.

OBSERVATIONS

At the initial examination, bilateral vitreous opacity, retinal exudates, mild vitreous hemorrhage, retinal vasculitis, and neovascularization of the retina and optic disc were observed. Although prednisolone was administered and panretinal photocoagulation was performed several times, recurrent vitreous hemorrhage continued. Since the vitreous hemorrhage was not absorbed, pars plana vitrectomy and lensectomy were performed. After surgery, neovascularization and intraocular inflammation decreased, and the corrected visual acuity in the right eye improved to 20/50. Histopathologic analysis of the proliferative membrane removed during surgery revealed substantial neovascularization and numerous neutrophils in the vessels.

CONCLUSIONS

Based on these findings, an inflammatory reaction as well as retinal ischemia were thought to be involved in the proliferative changes in this patient.

摘要

背景

结节病性葡萄膜炎偶尔会伴有增殖性改变,如视网膜新生血管形成和玻璃体出血。在这类增殖性病例中,可能需要使用类固醇、视网膜光凝术和玻璃体切除术。

病例

一名19岁女性患者,患有增殖性结节病性葡萄膜炎,并伴有反复玻璃体出血。

观察结果

初次检查时,发现双侧玻璃体混浊、视网膜渗出、轻度玻璃体出血、视网膜血管炎以及视网膜和视盘新生血管形成。尽管给予了泼尼松龙并多次进行全视网膜光凝术,但反复玻璃体出血仍持续存在。由于玻璃体出血未被吸收,遂进行了玻璃体切割术和晶状体切除术。术后,新生血管形成和眼内炎症减轻,右眼矫正视力提高到20/50。对手术中切除的增殖膜进行组织病理学分析,发现大量新生血管形成,血管内有大量中性粒细胞。

结论

基于这些发现,认为炎症反应以及视网膜缺血与该患者的增殖性改变有关。

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