Nagpal Amit, Biswas Jyotirmay
Medical and Vision Research Foundations, Sankara Nethralaya, Chennai, India.
Ocul Immunol Inflamm. 2006 Feb;14(1):13-20. doi: 10.1080/09273940500545627.
Analysis of non-uveitic entities that were referred as posterior uveitis to a uveitis referral center.
We came across and analyzed 32 cases of non-uveitic entities (1.12%) that had been misdiagnosed and referred as posterior uveitis out of 2846 outpatient cases of posterior uveitis registered from 1990 to June 2002. The final diagnosis was achieved by history, slit-lamp biomicroscopy, meticulous fundus evaluation, imaging, and ancillary studies.
The finally diagnosed 32 non-uveitic entities that mimicked posterior uveitis were multiple leak central serous retinopathy (n = 8; 25%), choroidal neovascular membrane (n = 6; 18.75%), typical central serous retinopathy (n = 4; 12.5%), dry form of age-related macular degeneration (n = 3; 9.3%), retinitis pigmentosa (n = 3; 9.3%), heredomacular degeneration (n = 3; 9.3%), myelinated nerve fibers (n = 2; 6.2%), malignant melanoma of the choroid (n = 1; 3.1%), old spontaneously reattached retinal detachment (n = 1; 3.1%), and subhyaloid hemorrhage (n = 1; 3.1%).
The purpose of the study was to underline the fact that there are some non-uveitic entities that mimic posterior uveitis and that an ophthalmologist can be deceived. The study highlights the problems diagnosing posterior uveitis and presents an algorithm of diagnostic approach to avoid misdiagnosis.
分析被转诊至葡萄膜炎转诊中心、被误诊为后葡萄膜炎的非葡萄膜炎性疾病。
在1990年至2002年6月登记的2846例后葡萄膜炎门诊病例中，我们发现并分析了32例（1.12%）被误诊为后葡萄膜炎的非葡萄膜炎性疾病。通过病史、裂隙灯生物显微镜检查、细致的眼底评估、影像学检查及辅助检查得出最终诊断。
最终诊断为模拟后葡萄膜炎的32例非葡萄膜炎性疾病为多发性渗漏性中心性浆液性视网膜病变（8例，25%）、脉络膜新生血管膜（6例，18.75%）、典型性中心性浆液性视网膜病变（4例，12.5%）、干性年龄相关性黄斑变性（3例，9.3%）、视网膜色素变性（3例，9.3%）、遗传性黄斑变性（3例，9.3%）、有髓神经纤维（2例，6.2%）、脉络膜恶性黑色素瘤（1例，3.1%）、陈旧性自发性视网膜脱离复位（1例，3.1%）及玻璃膜下出血（1例，3.1%）。
本研究目的在于强调存在一些模拟后葡萄膜炎的非葡萄膜炎性疾病，可能会误导眼科医生。该研究突出了后葡萄膜炎诊断中的问题，并提出了一种诊断方法流程以避免误诊。
