Ishikawa Sho, Sato Tomohito, Takayama Kei, Takeuchi Masaru
Department of Ophthalmology, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama-ken 359-8513, Japan.
Nippon Ganka Gakkai Zasshi. 2013 Jul;117(7):561-7.
Serpiginous choroiditis, a chronic disease affecting the choroid and retinal pigment epithelium, is characterized by acute lesions located adjacent to atrophic scars initiated from the peripapillary region. This report describes a chorioretinal disease accompanied with retinal phlebitis finally diagnosed as serpiginous choroiditis by the characteristic extension of the lesions.
A 68-year-old man was referred to our hospital with blurred vision in his both eyes. A small amount of cells infiltrating the vitreous, partial vitreous opacity, retinal phlebitis, grayish-white lesions around the optic disc and retinal phlebitis, and cystoid macular edema were observed in the both eyes. Since active lesions were found at the border of the inactive lesions and appeared in an interlocking polygonal pattern that spread out continuously, the condition was diagnosed as serpiginous choroiditis with retinal phlebitis. Systemic administration of predonisolone was initiated, which resolved the retinal phlebitis, and the active lesions were turned to scars. No recurrence has been observed since.
Atypical serpiginous choroiditis accompanied with retinal phlebitis responds to systemic steroid administration.
匐行性脉络膜炎是一种影响脉络膜和视网膜色素上皮的慢性疾病，其特征是在视乳头周围区域萎缩性瘢痕附近出现急性病变。本报告描述了一种伴有视网膜静脉炎的脉络膜视网膜疾病，最终通过病变的特征性扩展诊断为匐行性脉络膜炎。
一名68岁男性因双眼视力模糊转诊至我院。双眼均观察到少量玻璃体细胞浸润、部分玻璃体混浊、视网膜静脉炎、视盘周围灰白色病变及视网膜静脉炎，以及黄斑囊样水肿。由于在非活动性病变边界发现活动性病变，并呈连续扩展的互锁多边形模式，该病例被诊断为伴有视网膜静脉炎的匐行性脉络膜炎。开始全身应用泼尼松龙，视网膜静脉炎得到缓解，活动性病变转为瘢痕。此后未观察到复发。
伴有视网膜静脉炎的非典型匐行性脉络膜炎对全身应用类固醇治疗有反应。
