Hashida Noriyasu, Terubayashi Aya, Ohguro Nobuyuki
Department of Ophthalmology, Osaka University Medical School, Suita, Japan.
Cutan Ocul Toxicol. 2011 Mar;30(1):75-7. doi: 10.3109/15569527.2010.517231. Epub 2010 Oct 1.
To report a case of anterior segment findings of presumed ocular tuberculosis using anterior-segment optical coherence tomography (AS-OCT; Visante, Carl Zeiss Meditec, Inc., Dublin, CA, USA).
A 78-year-old woman with persistent right ocular injection and pain of 2 weeks' duration was referred to our clinic. Unilateral stromal keratitis affecting the corneal periphery and angle granuloma with synechiae, scleritis, and anterior uveitis were noticed. Because of the patient's intensely positive tuberculin skin test, she was diagnosed with presumed intraocular tuberculosis. The anatomic structures of the anterior segment were monitored by AS-OCT before and after the treatment.
AS-OCT imaging showed a poorly demarcated amorphous lesion in the iridocorneal angle, corneal edema, narrowing and synechiae of the iridocorneal angle, and anterior chamber exudates and cells. Improvement of the corneal edema and a decrease of corneal thickness and exudates were observed after implementation of a daily regimen of antituberculous treatment. AS-OCT was useful for investigating the extent of the anterior synechiae and angle lesions.
AS-OCT allows noninvasive and noncontact analysis of the treatment response and is also useful to evaluate disease activity.
报告1例疑似眼结核前段病变的病例，使用前段光学相干断层扫描（AS - OCT；Visante，卡尔蔡司医疗技术公司，美国加利福尼亚州都柏林）进行检查。
一名78岁女性因右眼持续充血和疼痛2周就诊于我院。检查发现存在累及角膜周边的单侧基质性角膜炎、伴有粘连的房角肉芽肿、巩膜炎和前葡萄膜炎。由于患者结核菌素皮肤试验呈强阳性，诊断为疑似眼内结核。在治疗前后，使用AS - OCT监测前段的解剖结构。
AS - OCT成像显示虹膜角膜角有界限不清的无定形病变、角膜水肿、虹膜角膜角变窄和粘连、前房渗出物及细胞。在实施每日抗结核治疗方案后，观察到角膜水肿有所改善，角膜厚度及渗出物减少。AS - OCT有助于研究前部粘连和房角病变的范围。
AS - OCT可对治疗反应进行无创、非接触式分析，也有助于评估疾病活动度。
