Suzuki Takahiro, Onouchi Hiromi, Nakagawa Yoshihiro, Oohashi Hideki, Kaiken Han, Kawai Kenji
Department of Ophthalmology, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
Tokai J Exp Clin Med. 2010 Dec 20;35(4):122-5.
To describe a case of recurrence of congenital ocular toxoplasmosis with frosted branch angiitis.
A 24-year-old woman presented with hyperemia in her right eye. Medical history included epilepsy at age 14 and mild mental retardation. Iridocyclitis and vitreous opacity were observed in the right eye, and furthermore widespread retinal vessel sheathing due to frosted branch angiitis was seen. Acyclovir was initiated for acute retinal necrosis with frosted branch angiitis. One week later, serologic tests showed elevated toxoplasma antibody level and toxoplasma antibody IgG level, and a white retinal exudative lesion with unclear margins was noted. Therefore, acetylspiramycin and prednisolone were initiated for a recurrence of congenital ocular toxoplasmosis. After treatment, inflammation subsided, the exudative lesion shrank, and the frosted branch angiitis improved.
We encountered a case of ocular toxoplasmosis due to recurrence of congenital toxoplasmosis with frosted branch angiitis. The clinical symptoms of ocular toxoplasmosis can be varied and the diagnosis should be kept in mind.
描述一例伴有霜样树枝状视网膜血管炎的先天性眼弓形虫病复发病例。
一名24岁女性因右眼充血就诊。病史包括14岁时患癫痫和轻度智力发育迟缓。右眼观察到虹膜睫状体炎和玻璃体混浊,此外还可见因霜样树枝状视网膜血管炎导致的广泛视网膜血管鞘。给予阿昔洛韦治疗急性视网膜坏死合并霜样树枝状视网膜血管炎。一周后,血清学检查显示弓形虫抗体水平和弓形虫IgG抗体水平升高,并发现一处边界不清的白色视网膜渗出性病变。因此,开始使用乙酰螺旋霉素和泼尼松龙治疗先天性眼弓形虫病复发。治疗后,炎症消退,渗出性病变缩小,霜样树枝状视网膜血管炎改善。
我们遇到一例因先天性弓形虫病复发伴霜样树枝状视网膜血管炎导致的眼弓形虫病病例。眼弓形虫病的临床症状可能多种多样,应牢记诊断。