Elluard M, Sitbon A, Barreau E
Service d'ophtalmologie, CHI André-Grégoire, 56, boulevard de la Boissière, 93105 Montreuil cedex, France.
J Fr Ophtalmol. 2013 Feb;36(2):124-8. doi: 10.1016/j.jfo.2011.10.016. Epub 2012 Sep 12.
Sectoral choroidal ischemia is a classic sign of giant cell arteritis, although the latter is more typically associated with anterior ischemic optic neuropathy or central retinal artery occlusion. We report the case of an acute choroidal ischemia in a 68-year-old, one-eyed patient, who presented with deterioration of visual acuity and metamorphopsia in his left eye (his right eye was counting fingers due to high myopia). Fundus examination revealed retinal pigment epithelium (RPE) alterations and slow choroidal perfusion on fluorescein angiography. Macular Optical Coherence Tomography (OCT) showed a total disruption of the photoreceptor layer. Although prompt corticosteroid therapy preserved some vision, secondary macular retinal pigment epithelial changes limited the visual outcome. No other ophthalmological signs were observed in follow-up.
扇形脉络膜缺血是巨细胞动脉炎的典型体征，尽管后者更典型地与前部缺血性视神经病变或视网膜中央动脉阻塞相关。我们报告了一例68岁单眼患者的急性脉络膜缺血病例，该患者左眼出现视力下降和视物变形（其右眼因高度近视仅能数指）。眼底检查发现视网膜色素上皮（RPE）改变，荧光素血管造影显示脉络膜灌注缓慢。黄斑光学相干断层扫描（OCT）显示光感受器层完全中断。尽管及时的皮质类固醇治疗保留了部分视力，但继发性黄斑视网膜色素上皮改变限制了视觉预后。随访中未观察到其他眼科体征。
