Moschos M M, Gatzioufas Z, Margetis I
Department of Ophthalmology, University of Athens, Athens, Greece.
Case Rep Ophthalmol. 2010 Dec 4;1(2):105-9. doi: 10.1159/000322913.
We report a case of a human leukocyte antigen B27 (HLA-B27)-negative patient with cystoid macular edema (CME) and ankylosing spondylitis (AS) after treatment with triamcinolone acetonide. The patient complained of deterioration of visual acuity of the right eye during the last 10 days. At presentation visual acuity of the right eye was 0.2, and the ophthalmic examination did not reveal any sign of active uveitis. Fluorescein angiography (FA) and ocular coherent tomography (OCT) showed CME. The left eye was normal with a visual acuity of 0.9. Eight weeks after intravitreal injection of triamcinolone acetonide, visual acuity improved to 0.8 and OCT revealed regression of macular edema. Six months later no recurrence was observed. Our case report indicates for the first time that CME may occur in AS independently of the presence of HLA-B27 and intraocular inflammation. Intravitreal use of triamcinolone acetonide can reduce macular edema and restore visual acuity.
我们报告一例人类白细胞抗原B27（HLA - B27）阴性的患者，在用曲安奈德治疗后出现黄斑囊样水肿（CME）和强直性脊柱炎（AS）。患者主诉右眼视力在过去10天内恶化。就诊时右眼视力为0.2，眼科检查未发现任何活动性葡萄膜炎迹象。荧光素血管造影（FA）和眼部相干断层扫描（OCT）显示有CME。左眼正常，视力为0.9。玻璃体内注射曲安奈德8周后，视力提高到0.8，OCT显示黄斑水肿消退。6个月后未观察到复发。我们的病例报告首次表明，AS患者中CME可能独立于HLA - B27的存在和眼内炎症而发生。玻璃体内使用曲安奈德可减轻黄斑水肿并恢复视力。
