Chawla H S, Goodwin J A, Ticho B H, Feist R M
Department of Ophthalmology, University of Illinois, Chicago School of Medicine.
Ann Ophthalmol. 1991 Jun;23(6):231-3.
Optic neuropathy with simultaneous orbital and sinus inflammation is a diagnostic dilemma. Although sinus inflammation was described previously as causative in some cases of optic neuritis, the relatively high rate of asymptomatic sinus opacification in radiologic studies of the general population (as high as 13%) makes this a diagnosis of exclusion. We describe a patient who had optic neuropathy associated with simultaneous orbital and sinus inflammation. Although definitive determination of etiology may not be made without tissue biopsy, cases suspected of having a bacterial etiology may benefit from an initial 48-hour trial of intravenous antibiotics before initiation of systemic corticosteroids.
伴有眼眶和鼻窦同时发炎的视神经病变是一个诊断难题。尽管鼻窦炎症在之前被描述为某些视神经炎病例的病因，但在普通人群的放射学研究中，无症状鼻窦混浊的发生率相对较高（高达13%），这使得该病成为一种排除性诊断。我们描述了一名患有与眼眶和鼻窦同时发炎相关的视神经病变的患者。尽管没有组织活检可能无法明确病因，但怀疑有细菌病因的病例在开始使用全身皮质类固醇之前，先进行48小时的静脉抗生素初始试验可能会有所帮助。
