Minami Rieko, Saito Wataru, Namba Kenichi, Ohno Shigeaki
Department of Ophthalmology and Visual Sciences, Hokkaido University Graduate School of Medicine, N 15, W 7, Kita-ku, Sapporo 060-8638, Japan.
Nippon Ganka Gakkai Zasshi. 2006 Sep;110(9):730-5.
Posterior scleritis is known to exhibit various changes in the ocular fundus, but retinochoroidal atrophy is a rare complication.
A 54-year-old man presented with the complaint of blurred vision in the right eye. The patient had visited our clinic twice before, 22 and 11 years earlier. Although his funduscopic findings had demonstrated choroidal detachment in both eyes, the cause could not be determined at that time.
His visual acuity was 20/200, OD and 20/100, OS. Funduscopic examination showed annual choroidal detachments and geographic retinochoroidal atrophy in the posterior pole OU, and serous retinal detachment OD. B-scan ultrasonograpy revealed diffuse thickening and flattening of the posterior coats of the eye, and orbital enhanced computed tomography revealed thickening and enhancement of the posterior sclera. A diagnosis of posterior scleritis was made. Prednisolone 80 mg/ day was initiated and gradually tapered. Nine months later choroidal and serous retinal detachment were resolved.
We encountered a rare case of posterior scleritis with associated extensive retinochoroidal atrophy. We speculated that the cause was inflammation of the retina and choroid, and accumulation of subretinal fluid for a long period.
已知后巩膜炎可导致眼底出现各种变化，但视网膜脉络膜萎缩是一种罕见的并发症。
一名54岁男性因右眼视力模糊前来就诊。该患者在22年前和11年前曾两次到我们诊所就诊。尽管当时眼底检查发现双眼脉络膜脱离，但病因未明确。
其右眼视力为20/200，左眼视力为20/100。眼底检查显示双眼后极部有每年发作的脉络膜脱离和地图状视网膜脉络膜萎缩，右眼有浆液性视网膜脱离。B超检查显示眼球后部脉络膜弥漫性增厚和平坦，眼眶增强计算机断层扫描显示后巩膜增厚和强化。诊断为后巩膜炎。开始使用泼尼松龙80毫克/天，并逐渐减量。九个月后，脉络膜和浆液性视网膜脱离消失。
我们遇到了一例罕见的伴有广泛视网膜脉络膜萎缩的后巩膜炎病例。我们推测病因是视网膜和脉络膜炎症以及长期视网膜下液积聚。
