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[眼部炎性疾病患者中韦格纳肉芽肿的诊断]

[Diagnosis of Wegener's granulomatosis in patients with ocular inflamatory disease].

作者信息

García Cynthia, Voorduin Stephanie, Pedroza-Seres Miguel

机构信息

Departamento de Uveítis e Inmunología Ocular, Instituto de Oftalmología Fundación Conde de Valenciana I.A.P., México D.F., México.

出版信息

Gac Med Mex. 2006 Nov-Dec;142(6):477-82.

Abstract

OBJECTIVE

Report the ophthalmologic manifestations among patients with Wegener 's Granulomatosis (WG).

METHOD

We reviewed the database of the Instituto de Oftalmologia Fundación Conde de Valenciana in order to collect information regarding complete ophthalmic examination, laboratory and cabinet tests, treatment, and disease progression.

RESULTS

We included 11 patients with WG (18 eyes). Seven men and four women, mean age 43.7 years (range = 28-55). Three patients had a prior diagnosis of WG and the remaining eight patients were diagnosed by our study team. Seven subjects developed a bilateral affection and four had unilateral involvement. The clinical presentation was necrotizing scleritis with peripheral ulcerative keratitis (PUK) (7/18), diffuse scleritis (3/18), nodular scleritis (1/18), non-granulomatous uveitis (1/18), optic ischemic neuropathy (1/18), retrobulbar neuritis (1/18), serous retinal detachment (2/18), and dacryocystitis (2/18). Final visual acuity was better or equal to 20/40 (13/18), 20/400 (3/18), finger-counting or no-perception of light in 1/18. Currently, seven patients are symptom free.

CONCLUSIONS

The most frequent ophthalmic manifestations among our patients with WG were: necrotizing scleritis and PUK. In most cases, WG was diagnosed after ophthalmic manifestations; however, all patients displayed prior systemic or ocular symptoms.

摘要

目的

报告韦格纳肉芽肿(WG)患者的眼科表现。

方法

我们查阅了瓦伦西亚伯爵基金会眼科研究所的数据库,以收集有关完整眼科检查、实验室和门诊检查、治疗及疾病进展的信息。

结果

我们纳入了11例WG患者(18只眼)。7名男性和4名女性,平均年龄43.7岁(范围=28 - 55岁)。3例患者先前已诊断为WG,其余8例由我们的研究团队诊断。7例患者出现双侧病变,4例为单侧受累。临床表现为坏死性巩膜炎伴周边溃疡性角膜炎(PUK)(7/18)、弥漫性巩膜炎(3/18)、结节性巩膜炎(1/18)、非肉芽肿性葡萄膜炎(1/18)、视神经缺血性神经病变(1/18)、球后视神经炎(1/18)、浆液性视网膜脱离(2/18)和泪囊炎(2/18)。最终视力优于或等于20/40(13/18)、20/400(3/18),1/18为手指计数或无光感。目前,7例患者无症状。

结论

我们的WG患者中最常见的眼科表现为:坏死性巩膜炎和PUK。在大多数情况下,WG在眼科表现出现后才被诊断;然而,所有患者均有先前的全身或眼部症状。

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