Lu Cheng-Wei, Zhou Dan-Dan, Wang Jiao, Hao Ji-Long
Department of Ophthalmology, The First Hospital of Jilin University, Changchun, Jilin, China. E-mail.
Saudi Med J. 2016 Feb;37(2):205-7. doi: 10.15537/smj.2016.2.13390.
The efficacy of surgical management of refractory ophthalmic complications of granulomatosis with polyangiitis (GPA), which is a sight threatening was reported. A 70-year-old man presented with a progressively worsening pain and redness in his right eye during the previous 6 months, and decreasing visual acuity that started one month earlier. He was misdiagnosed and treated as keratitis elsewhere, but the pain has not decreased. The diagnosis of necrotizing scleritis with peripheral ulcerative keratitis (PUK) in GPA was made in our department. Surgery was performed with necrotic tissue removal, combined with cryotherapy and a conjunctival flap covering surgery. The symptom was relieved after surgery, and the patient's ocular condition remained stable thereafter. This case first demonstrates limited ophthalmic GPA (such as, PUK and necrotizing scleritis) that was not sensitive or aggravated for traditional methods can be successfully treated by combined surgical interventions.
据报道，手术治疗肉芽肿性多血管炎（GPA）难治性眼部并发症的疗效显著，该并发症可威胁视力。一名70岁男性在过去6个月中右眼疼痛和发红逐渐加重，视力在1个月前开始下降。他在其他地方被误诊为角膜炎并接受治疗，但疼痛并未减轻。我院诊断为GPA合并坏死性巩膜炎伴周边溃疡性角膜炎（PUK）。手术切除坏死组织，联合冷冻治疗和结膜瓣覆盖手术。术后症状缓解，患者眼部状况此后保持稳定。该病例首次表明，对于传统方法不敏感或病情加重的局限性眼部GPA（如PUK和坏死性巩膜炎），可通过联合手术干预成功治疗。
