Ugarte Marta, Dey Sarju, Jones Carole A
Manchester Academic Health Sciences Centre and NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, UK.
BMJ Case Rep. 2010 Nov 19;2010:bcr1220092532. doi: 10.1136/bcr.12.2009.2532.
An 80-year-old Caucasian woman had been diagnosed with right herpes zoster ophthalmicus 2 ½ weeks before presentation to our department. Ten days after stopping oral aciclovir, she presented with periorbital pain, visual loss, ptosis and complete ophthalmoplegia. On examination, visual acuity in her right eye was hand movements, with a relative afferent pupillary defect and 2 mm proptosis. MRI demonstrated contrast enhancement within the orbit extending into the apex, suggestive of an inflammatory process. Oral treatment was started with oral aciclovir and corticosteroids for 2 months, when she had resolution of the optic neuropathy and ophthalmoplegia. Vision recovered to 6/9 and repeat neuroimaging revealed regression of the inflammatory process.
一名80岁的白种女性在到我们科室就诊前2.5周被诊断为右眼带状疱疹性眼炎。停用口服阿昔洛韦10天后，她出现眶周疼痛、视力丧失、上睑下垂和完全性眼肌麻痹。检查发现，她右眼的视力为手动，伴有相对传入性瞳孔障碍和眼球突出2毫米。磁共振成像（MRI）显示眼眶内有对比增强，延伸至眶尖，提示有炎症过程。开始口服阿昔洛韦和皮质类固醇进行治疗，持续2个月，之后她的视神经病变和眼肌麻痹得到缓解。视力恢复到6/9，重复神经影像学检查显示炎症过程消退。
