角膜穿孔作为一名患有潜在类风湿性关节炎患者圆锥角膜的主要表现。
Corneal perforation as a primary manifestation of keratoconus in a patient with underlying rheumatoid arthritis.
作者信息
Tsaousis Konstantinos T, Chalvatzis Nikolaos, Symeonidis Chrysanthos, Kopsachilis Nikolaos, Mataftsi Asimina, Dimitrakos Stavros A, Tsinopoulos Ioannis T
机构信息
2nd Department of Ophthalmology, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, 56429, Thessaloniki, Greece,
出版信息
J Ophthalmic Inflamm Infect. 2012 Mar;2(1):57-60. doi: 10.1007/s12348-011-0048-4. Epub 2011 Nov 17.
PURPOSE
The purpose of this study is to report a case of corneal perforation in a patient with undiagnosed keratoconus and underlying rheumatoid arthritis.
METHODS
This is a retrospective case study based on the patient's medical records and followed by a brief review of the literature.
RESULTS
A 53-year-old patient was referred to our department for acute pain and sudden decrease of visual acuity in his left eye. Corneal perforation was detected and attributed to a previously undiagnosed and untreated keratoconus. Additional laboratory work-up and clinical examination revealed a coexisting rheumatoid arthritis. Amniotic membrane was originally transplanted in order to maintain the structural integrity and promote healing of the perforated eye. Subsequently, the patient underwent a penetrating keratoplasty, though with unfavorable results due to postoperative endophthalmitis.
CONCLUSIONS
Rheumatoid arthritis may be associated with higher risk of corneal perforation in patients with ectatic degenerative diseases such as keratoconus.
目的
本研究旨在报告一例患有未确诊圆锥角膜及潜在类风湿性关节炎患者发生角膜穿孔的病例。
方法
这是一项基于患者病历的回顾性病例研究，并随后对文献进行简要综述。
结果
一名53岁患者因左眼急性疼痛和视力突然下降被转诊至我科。检测发现角膜穿孔，病因是此前未确诊和未治疗的圆锥角膜。进一步的实验室检查和临床检查显示同时存在类风湿性关节炎。最初移植羊膜以维持穿孔眼的结构完整性并促进愈合。随后，患者接受了穿透性角膜移植术，但由于术后眼内炎，效果不佳。
结论
类风湿性关节炎可能与扩张性退行性疾病（如圆锥角膜）患者发生角膜穿孔的较高风险相关。
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