Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA.
Retina. 2010 Feb;30(2):310-6. doi: 10.1097/iae.0b013e3181b773fc.
The purpose of this study was to describe patients initially carrying a diagnosis of primary intraocular lymphoma who were ultimately diagnosed with ocular sarcoidosis.
The medical records of patients evaluated between 1995 and 2007 fitting the criteria described earlier were identified, and pertinent clinical findings allowing for the diagnosis of sarcoidosis are described.
Nine patients between the ages of 52 and 83 were referred with a diagnosis of primary intraocular lymphoma but were ultimately diagnosed with sarcoidosis. The most common clinical signs found in these patients that are atypical for primary intraocular lymphoma but common in sarcoidosis were multifocal choroiditis (n = 7) and cystoid macular edema (n = 6). Additional findings included keratic precipitates, posterior synechiae, and Koeppe nodules. Chest computerized tomography was consistent with sarcoidosis in seven of eight tested patients, and five of these patients had normal chest x-rays. Other findings included elevated angiotensin-converting enzyme and/or lysozyme, and biopsy revealing noncaseating granulomas.
Although primary intraocular lymphoma should always be in the differential diagnosis of older patients who present with signs of ocular inflammation, ophthalmologists must also consider other etiologies, including sarcoidosis. A chest computerized tomography may be helpful in the diagnosis, particularly when laboratory findings are supportive of sarcoidosis.
本研究旨在描述最初被诊断为原发性眼内淋巴瘤但最终被诊断为眼结节病的患者。
确定了在 1995 年至 2007 年间符合上述标准接受评估的患者的病历，并描述了有助于诊断结节病的相关临床发现。
9 名年龄在 52 至 83 岁之间的患者被诊断为原发性眼内淋巴瘤，但最终被诊断为结节病。这些患者最常见的临床体征是非典型原发性眼内淋巴瘤但常见于结节病的多灶性脉络膜炎（n = 7）和囊样黄斑水肿（n = 6）。其他发现包括角膜沉淀物、后粘连和 Koepoe 结节。在接受检查的 8 名患者中的 7 名中，胸部计算机断层扫描与结节病一致，其中 5 名患者的胸部 X 光正常。其他发现包括血管紧张素转换酶和/或溶菌酶升高，活检显示非坏死性肉芽肿。
尽管原发性眼内淋巴瘤应始终作为出现眼部炎症迹象的老年患者的鉴别诊断，但眼科医生还必须考虑其他病因，包括结节病。胸部计算机断层扫描可能有助于诊断，特别是当实验室发现支持结节病时。
