Sugahara Michitaka, Fujimoto Takayuki, Shidara Kyoko, Inoue Kenji, Wakakura Masato
Inouye Eye Hospital, Tokyo, Japan.
Clin Ophthalmol. 2013;7:1023-6. doi: 10.2147/OPTH.S42678. Epub 2013 May 29.
Here, we describe a patient who presented with anterior ischemic optic neuropathy (AION) and subsequently developed uveitis.
A 69-year-old man was referred to our hospital and initially presented with best-corrected visual acuities (BCVA) of 20/40 (right eye) and 20/1000 (left eye) and relative afferent pupillary defect. Slit-lamp examination revealed no signs of ocular inflammation in either eye. Fundus examination revealed left-eye swelling and a pale superior optic disc, and Goldmann perimetry revealed left-eye inferior hemianopia. The patient was diagnosed with nonarteritic AION in the left eye. One week later, the patient returned to the hospital because of vision loss. The BCVA of the left eye was so poor that the patient could only count fingers. Slit-lamp examination revealed 1+ cells in the anterior chamber and the anterior vitreous in both eyes. Funduscopic examination revealed vasculitis and exudates in both eyes. The patient was diagnosed with bilateral panuveitis, and treatment with topical betamethasone was started. No other physical findings resulting from other autoimmune or infectious diseases were found. No additional treatments were administered, and optic disc edema in the left eye improved, and the retinal exudates disappeared in 3 months. The patient's BCVA improved after cataract surgery was performed.
Panuveitis most likely manifests after the development of AION.
在此，我们描述一名出现前部缺血性视神经病变（AION）并随后发展为葡萄膜炎的患者。
一名69岁男性被转诊至我院，初诊时右眼最佳矫正视力（BCVA）为20/40，左眼为20/1000，伴有相对性传入瞳孔障碍。裂隙灯检查显示双眼均无眼部炎症迹象。眼底检查发现左眼肿胀，视盘上半苍白，Goldmann视野检查显示左眼下方偏盲。该患者被诊断为左眼非动脉炎性AION。一周后，患者因视力下降再次入院。左眼BCVA极差，患者仅能数指。裂隙灯检查显示双眼前房和前部玻璃体有1+细胞。眼底检查发现双眼血管炎和渗出物。该患者被诊断为双侧全葡萄膜炎，并开始局部使用倍他米松治疗。未发现由其他自身免疫性或感染性疾病引起的其他体征。未给予其他治疗，左眼视盘水肿改善，视网膜渗出物在3个月内消失。白内障手术后患者的BCVA有所改善。
全葡萄膜炎很可能在AION发生后出现。
