Huerva V, Canto L M, Espinet R, Torres G, Berlanga B
Hospital Arnau de Vilanova y Hospital de Santa María, Lérida, España.
Arch Soc Esp Oftalmol. 2002 May;77(5):275-8.
A 41-year-old man presented a clinical picture characterized by lymphocytic meningoencephalitis, visual loss in both eyes and transverse sinus thrombosis. This picture was treated with prednisone and anticoagulation. Fundus examination showed complete occlusive arteritis, periphlebitis, peripheral ischemia and perfusion macular defects affecting both eyes. The picture was suggestive of Behçet's disease. Azathioprine was added to the treatment without improvement in visual acuity. Four months later oral aphthous ulcers developed, confirming the suspected diagnosis.
Behçet's disease may appear with the sudden onset of visual loss secondary to massive occlusive retinal vasculitis. The critical state of neuro-Behçet disease may delay the diagnosis. This combination of visual and neurological symptoms is associated with a poor visual prognosis (Arch Soc Esp Oftalmol 2002; 77: 275-278).
一名41岁男性表现出以淋巴细胞性脑膜脑炎、双眼视力丧失和横窦血栓形成为特征的临床症状。针对此症状采用泼尼松和抗凝治疗。眼底检查显示双眼均存在完全闭塞性动脉炎、静脉周围炎、周边缺血以及黄斑灌注缺损。此症状提示为白塞病。在治疗中加用硫唑嘌呤，但视力并未改善。四个月后出现口腔阿弗他溃疡，证实了疑似诊断。
白塞病可能因大量闭塞性视网膜血管炎继发视力丧失而突然起病。神经白塞病的危急状态可能会延迟诊断。这种视觉和神经症状的组合与不良的视力预后相关（《西班牙眼科协会档案》2002年；77: 275 - 278）。
