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[与巨细胞动脉炎相关的前部缺血性视神经病变。病例报告]

[Anterior ischemic optic neuropathy associated with giant cell arteritis. Case report].

作者信息

Obuchowska Iwona, Mariak Zofia, Budrowski Radosław

机构信息

Klinika Okulistyki Akademii Medycznej w Białymstoku.

出版信息

Klin Oczna. 2006;108(1-3):124-7.

Abstract

Giant cell arteritis is a systemic vasculitis that affects large- and medium sized arteries. The most common ophthalmic manifestation of this disease is anterior ischemic optic neuropathy, leading to acute, painless visual loss in one or both eyes. It is caused by ischemia of the optic nerve head, which is mainly supplied by the short posterior ciliary arteries. Early diagnosis is the key to correct management and prevention of visual loss in the second eye. The treatment of choice for arteritic ischemic optic neuropathy is high dose of systemic corticosteroids. Only such treatment may prevent blindness. The authors presented a case of a 62 years man with anterior ischemic neuropathy in one eye, which was diagnosed as arteritic form caused by giant cell arteritis. The correct diagnosis was based on typical clinical signs of ischemic changes in the optic nerve head and diagnostic criteria for giant cell arteritis, advocated by American College of Rheumatologists.

摘要

巨细胞动脉炎是一种影响大中动脉的系统性血管炎。该病最常见的眼部表现是前部缺血性视神经病变,可导致单眼或双眼急性无痛性视力丧失。它是由主要由睫状后短动脉供血的视神经乳头缺血引起的。早期诊断是正确治疗和预防对侧眼视力丧失的关键。动脉炎性缺血性视神经病变的首选治疗方法是大剂量全身使用糖皮质激素。只有这种治疗方法才能预防失明。作者报告了一例62岁男性患者,其一只眼睛患有前部缺血性神经病变,诊断为巨细胞动脉炎引起的动脉炎性类型。正确的诊断基于视神经乳头缺血改变的典型临床体征以及美国风湿病学会倡导的巨细胞动脉炎诊断标准。

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