Rusu V, Baltag D, Puiu D, Popovici M, Neamţu N
Clinica I Oftalmologie, Spitalul Sf. Spiridon, Iaşi.
Oftalmologia. 1999;48(3):79-81.
The issue discusses the diagnosis difficulties concerning the case of 58-years-old woman who was watched for a recurrent exophthalmos after a mild conjunctival trauma. The debut was orbital cellulite appearance, complicated by a nonaxial exophthalmos due to a dacryoadenitis. The exophthalmos is axial in the other two recurrences. All exophthalmic episodes progressed with inflammatory features associated with optic neuritis and oculomotor nerves implication without any neurological signs. The paraclinical tests (ECHO, orbital radiography, CAT) find inflammation of orbital elements: extrinsic muscles and lacrimal gland. Biochemical tests showed minimal inflammatory changes without be able to provide the positive diagnosis. Initial combined therapy (antibiotics and steroids), then steroid monotherapy had favorable response.
该病例讨论了一名58岁女性在轻度结膜创伤后出现复发性眼球突出的诊断困难。首发表现为眼眶蜂窝织炎，并发泪腺炎导致非轴性眼球突出。另外两次复发时眼球突出为轴性。所有眼球突出发作均伴有与视神经炎和动眼神经受累相关的炎症特征，但无任何神经体征。辅助检查（超声、眼眶X线摄影、计算机断层扫描）发现眼眶结构（眼外肌和泪腺）有炎症。生化检查显示炎症变化轻微，无法做出肯定诊断。初始联合治疗（抗生素和类固醇），随后采用类固醇单一疗法取得了良好疗效。
