玻璃体内注射贝伐单抗治疗一例伴有梅毒性眼内炎症的闭塞性视网膜血管炎
Intravitreal injection of bevacizumab in a case of occlusive retinal vasculitis accompanied by syphilitic intraocular inflammation.
作者信息
Ishijima Kan, Namba Kenichi, Ohno Shigeaki, Mochizuki Kiyofumi, Ishida Susumu
机构信息
Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
出版信息
Case Rep Ophthalmol. 2012 Sep;3(3):434-7. doi: 10.1159/000346046. Epub 2012 Dec 22.
BACKGROUND
We report a rare case of syphilitic intraocular inflammation with occlusive retinal vasculitis treated with intravitreal injection of bevacizumab (IVB) in addition to conventional therapy for syphilis.
CASE
A 24-year-old woman who complained floaters in both her eyes showed occlusive retinal vasculitis OU. According to the high titer of the Treponema antigen and characteristic cutaneous eruption, she was diagnosed as secondary syphilis.
OBSERVATION
She was treated with oral amoxicillin and retinal photocoagulation OU. Then, administration of prednisolone was required to the intraocular inflammations considered as Jarisch-Herxheimer reactions. IVB was also performed toward exacerbated retinal neovascularization and showed transient effects.
CONCLUSION
We experienced a rare case of occlusive retinal vasculitis accompanied by syphilis intraocular inflammation. IVB was considered to be effective as an adjunctive therapy for inflammatory neovascularizations.
背景
我们报告了一例罕见的梅毒相关性眼内炎症合并闭塞性视网膜血管炎的病例，除了采用常规梅毒治疗外，还通过玻璃体内注射贝伐单抗（IVB）进行治疗。
病例
一名24岁女性，主诉双眼有飞蚊症，检查发现双眼存在闭塞性视网膜血管炎。根据梅毒螺旋体抗原高滴度及特征性皮肤疹，她被诊断为二期梅毒。
观察
给予口服阿莫西林及双眼视网膜光凝治疗。随后，针对被认为是雅里施-赫克斯海默反应的眼内炎症，需要使用泼尼松龙。针对加重的视网膜新生血管也进行了IVB治疗，显示出短暂的效果。
结论
我们遇到了一例罕见的伴有梅毒眼内炎症的闭塞性视网膜血管炎病例。IVB被认为作为炎症性新生血管的辅助治疗是有效的。
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