黄斑梗死作为系统性红斑狼疮的首发症状
Macular infarction as a presenting sign of systemic lupus erythematosus.
作者信息
Shein Jean, Shukla Dhananjay, Reddy Shantan, Yannuzzi Lawrence A, Cunningham Emmett T
机构信息
From the *Department of Ophthalmology, New York University School of Medicine, New York, New York; †Aravind Eye Hospital & Post-Graduate Institute of Ophthalmology, Tamil Nadu, India; and ‡Vitreous-Retina-Macula Consultants of New York, New York, New York.
出版信息
Retin Cases Brief Rep. 2008 Winter;2(1):55-60. doi: 10.1097/ICB.0b013e3180590c7d.
PURPOSE
We report two cases of macular infarction as a presenting sign of systemic lupus erythematosus (SLE).
METHODS
Ophthalmic examination and intravenous fluorescein angiography were supplemented by rheumatology consultations and imaging.
RESULTS
Two patients presented with complaints of decreased vision in one or both eyes. Systemic manifestations included fever, rash, and arthralgias, while serologic tests revealed an elevated erythrocyte sedimentation rate and positive antinuclear antibody titers in both cases, confirming the diagnosis of SLE in each case. Ophthalmoscopic changes included cotton-wool spots, intraretinal hemorrhages, and retinal edema. Fluorescein angiography revealed macular infarction with extensive retinal capillary nonperfusion in both patients.
CONCLUSION
Macular infarction is an uncommon but recognized complication of vasculitis associated with SLE. We report two additional cases of newly diagnosed SLE where vision loss secondary to macular infarction was the presenting sign of the disease. SLE should be considered in all patients who present with macular infarction. Visual prognosis is usually poor.
目的
我们报告两例黄斑梗死作为系统性红斑狼疮（SLE）的首发症状。
方法
眼科检查和静脉荧光素血管造影辅以风湿病会诊和影像学检查。
结果
两名患者均主诉一只或两只眼睛视力下降。全身表现包括发热、皮疹和关节痛，而血清学检查显示两例患者红细胞沉降率均升高且抗核抗体滴度呈阳性，确诊为SLE。眼底镜检查改变包括棉絮斑、视网膜内出血和视网膜水肿。荧光素血管造影显示两名患者均有黄斑梗死伴广泛视网膜毛细血管无灌注。
结论
黄斑梗死是与SLE相关的血管炎一种罕见但已被认识的并发症。我们报告另外两例新诊断的SLE病例，其中黄斑梗死继发的视力丧失是该疾病的首发症状。所有出现黄斑梗死的患者均应考虑SLE。视力预后通常较差。
Zotero 插件