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一例罕见的双侧多灶性视网膜色素上皮脱离合并甲醇所致视神经炎病例。

An unusual case of bilateral multifocal retinal pigment epithelial detachment with methanol-induced optic neuritis.

作者信息

Ranjan Ratnesh, Kushwaha Rajnath, Gupta Ramesh Chandra, Khan Perwez

机构信息

Department of Ophthalmology, GSVM Medical College, Kanpur, 208002, India,

出版信息

J Med Toxicol. 2014 Mar;10(1):57-60. doi: 10.1007/s13181-013-0329-4.

Abstract

PURPOSE

To describe an unusual case of methanol-induced optic neuritis with bilateral multifocal extrafoveal serous retinal pigment epithelial (RPE) detachment.

METHODS

Single case report.

CASE REPORT

A 40-year-old male presented with acute bilateral loss of vision and history of consumption of adulterated alcohol. On examination, his vision was perception of light in the right eye and finger counting at 1-ft distance in the left eye. Pupillary reactions were sluggish. The optic discs were normal. An elevated lesion with subretinal serous fluid was present over macula adjacent to superior major vessel arcade in the right eye, which was confirmed as a large extrafoveal RPE detachment on fluorescein angiography. There were two more small RPE detachments in the right eye as well as in the left eye. All RPE detachments were extrafoveal in location. The patient was managed medically with intravenous methylprednisolone (1 g) in 500 ml of ringer lactate for three consecutive days. After three doses, visual acuity of both eyes was recorded as 20/20.

CONCLUSION

We herein report an unusual case of bilateral multifocal extrafoveal serous RPE detachment in a patient of methanol-induced optic neuritis. RPE detachments may be due to the toxic effect of methanol metabolites.

摘要

目的

描述一例甲醇所致视神经炎伴双侧多灶性黄斑外浆液性视网膜色素上皮(RPE)脱离的罕见病例。

方法

单病例报告。

病例报告

一名40岁男性,因急性双侧视力丧失就诊,有饮用掺假酒精的病史。检查发现,其右眼视力为光感,左眼视力为1英尺处手指计数。瞳孔反应迟钝。视盘正常。右眼在与上方主要血管弓相邻的黄斑区有一个伴有视网膜下浆液性液体的隆起病变,荧光素血管造影证实为一个大的黄斑外RPE脱离。右眼和左眼还有另外两个小的RPE脱离。所有RPE脱离均位于黄斑外。患者接受了连续三天静脉注射500毫升乳酸林格液中加入1克甲泼尼龙的药物治疗。三剂后,双眼视力记录为20/20。

结论

我们在此报告一例甲醇所致视神经炎患者出现双侧多灶性黄斑外浆液性RPE脱离的罕见病例。RPE脱离可能是由于甲醇代谢产物的毒性作用。

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