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单侧急性特发性黄斑病变的临床发现:急性特发性黄斑病变的新发现

Clinical findings in unilateral acute idiopathic maculopathy: new findings in acute idiopathic maculopathy.

作者信息

Haruta Hiroshi, Sawa Miki, Saishin Yoshitsugu, Ohguro Nobuyuki, Tano Yasuo

机构信息

Department of Ophthalmology, Osaka University Medical School, Room E7, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.

出版信息

Int Ophthalmol. 2010 Apr;30(2):199-202. doi: 10.1007/s10792-009-9299-6. Epub 2009 Jan 29.

Abstract

We report a case of unilateral acute idiopathic maculopathy (UAIM) with new clinical findings. A 34-year-old Japanese man had a neurosensory retinal detachment (approximately 5 disk diameters) with yellowish-white exudates at the macula in the left eye (visual acuity (VA) 0.4). Fluorescein angiography (FA) showed early hypofluorescent spots and late pooling in the subretinal space. Three weeks after onset, indocyanine green angiography (IA) showed numerous hypofluorescent spots at the lesion. Optical coherence tomography (OCT) showed subretinal fluids and an elevated choroidal lesion with low reflectivity, suggesting choroidal edema. The VA and fundus appearance spontaneously resolved without treatment three months after onset. The VA was 1.0 six months after onset. Irregular pigmentation remained at the macular lesion. The main UAIM pathology may be outer retinal layer and retinal pigment epithelial inflammation. FA, IA, and OCT suggested that choroidal inflammation may be involved in the pathogenesis of UAIM.

摘要

我们报告一例具有新临床发现的单侧急性特发性黄斑病变(UAIM)。一名34岁的日本男性左眼黄斑区出现神经感觉性视网膜脱离(约5个视盘直径),伴有黄白色渗出物(视力(VA)0.4)。荧光素血管造影(FA)显示早期低荧光点和晚期视网膜下间隙渗漏。发病三周后,吲哚菁绿血管造影(IA)显示病变处有大量低荧光点。光学相干断层扫描(OCT)显示视网膜下液和脉络膜病变隆起,反射率低,提示脉络膜水肿。发病三个月后未经治疗,视力和眼底外观自发恢复。发病六个月后视力为1.0。黄斑病变处仍有不规则色素沉着。UAIM的主要病理可能是视网膜外层和视网膜色素上皮炎症。FA、IA和OCT提示脉络膜炎症可能参与UAIM的发病机制。

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