Courtade M, Gicquel J J, Mercie M, Vabres B, Dighiero P
Service d'Ophtalmologie, CHU de Poitiers.
J Fr Ophtalmol. 2004 Oct;27(8):918-20. doi: 10.1016/s0181-5512(04)96237-7.
To report a case of recurrent granulomatous panuveitis associated with CREST syndrome.
A 74-year-old patient with CREST syndrome presented with unilateral granulomatous panuveitis in a pseudophakic eye. She had undergone cataract surgery 6 months before. The patient reported a vision loss that had been evolving for 1 month. Visual acuity was noted at 20/400. The initial clinical examination highlighted retrodescemetic precipitates and granulomatous precipitates on the IOL. A vitreous tyndall was noted. Funduscopic examination revealed papillary edema and cystoid macular edema, confirmed by fluorescein angiography.
Topical treatment consisting in corticosteroid eye drops associated with mydriatics controlled uveitis in a few weeks. Visual recovery was 20/30. No granulomatous uveitis etiology could be highlighted. The diagnosis of chronic endophthalmitis was also ruled out.
The diagnosis retained was uveitis associated with CREST syndrome. To our knowledge, this association has only been reported twice in the literature.
报告一例与CREST综合征相关的复发性肉芽肿性全葡萄膜炎病例。
一名患有CREST综合征的74岁患者，在一只人工晶状体眼出现单侧肉芽肿性全葡萄膜炎。她在6个月前接受了白内障手术。患者报告视力下降已有1个月。视力为20/400。初始临床检查发现后弹力层沉积物和人工晶状体上的肉芽肿性沉积物。可见玻璃体混浊。眼底检查发现视乳头水肿和黄斑囊样水肿，荧光素血管造影证实。
局部使用皮质类固醇滴眼液联合散瞳剂治疗，几周内控制了葡萄膜炎。视力恢复到20/30。未发现肉芽肿性葡萄膜炎的病因。慢性眼内炎的诊断也被排除。
最终诊断为与CREST综合征相关的葡萄膜炎。据我们所知，这种关联在文献中仅被报道过两次。
