Januschowski K, Wilhelm H
Department für Augenheilkunde, Universitätsaugenklinik, Tübingen.
Klin Monbl Augenheilkd. 2012 Nov;229(11):1079-82. doi: 10.1055/s-0032-1315248. Epub 2012 Sep 7.
We report two cases of atypical temporal arteritis. A 73-year-old woman with typical internal (diabetes, hypertony, hypercholesterinemia) and ophthomological (optic disc drusen) risk factors for N-AION reported with an acute unilateral decrease in vision. General symptoms, laboratory analysis and biopsy led to the diagnosis of temporal arteritis and iv steroids were administered. An 83-year-old male patient reported with a sudden unilateral decrease in vision, but did not complain about general symptoms. Laboratory analysis revealed no signs for temporal arteritis, therefore the patient was referred to his internal specialist for evaluation of internal risk factors for N-AION. A few days later the patient reported with a unilateral decrease in vision of the partner eye. This time blood analysis was suggestive of temporal arteritis although no general symptoms were reported. Diagnosis was supported by a biopsy of the temporal artery and steroids were administered. These two cases teach us how dangerously easy temporal arteritis can be overlooked and that we have to take even the slightest hint for temporal arteritis seriously and initiate treatment as early as possible.
我们报告两例非典型颞动脉炎病例。一名73岁女性,有典型的内科(糖尿病、高血压、高胆固醇血症)和眼科(视盘玻璃膜疣)导致非动脉炎性前部缺血性视神经病变(N - AION)的危险因素,因急性单眼视力下降前来就诊。综合症状、实验室检查及活检确诊为颞动脉炎,并给予静脉注射类固醇治疗。一名83岁男性患者因突然单眼视力下降前来就诊,但无全身症状主诉。实验室检查未发现颞动脉炎迹象,因此该患者被转至内科专家处评估导致N - AION的内科危险因素。几天后,该患者对侧眼出现视力下降。此次血液分析提示颞动脉炎,尽管仍无全身症状报告。颞动脉活检支持诊断,并给予类固醇治疗。这两例病例告诉我们,颞动脉炎多么容易被危险地忽视,我们必须认真对待哪怕最轻微的颞动脉炎迹象,并尽早开始治疗。