诊断为视神经视网膜炎的转诊患者的最终诊断
Final Diagnosis in Patients Referred with a Diagnosis of Neuroretinitis.
作者信息
Kahloun Rim, Khairallah-Ksiaa Imen, Abroug Nesrine, Mahmoud Anis, Ben Yahia Salim, Zaouali Sonia, Jelliti Bechir, Khairallah Moncef
机构信息
Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir, Tunisia.
出版信息
Neuroophthalmology. 2015 Dec 14;39(6):266-270. doi: 10.3109/01658107.2015.1092561. eCollection 2015 Dec.
The purpose of this study was to determine final diagnosis of patients referred with a diagnosis of neuroretinitis. A retrospective study of 40 patients with optic disc oedema with macular star (ODOMS) referred with a diagnosis of neuroretinitis was conducted. The final diagnosis was neuroretinitis in 26 patients (65%), with most of these patients (96.1%) having unilateral involvement. Main underlying aetiologies included cat scratch disease (30.8%), rickettsiosis (19.2%), and idiopathic neuroretinitis (23.1%). The remaining 14 patients (35%) had ODOMS that had been mistaken for neuroretinitis. Of these patients, 42.8% were found to have a previously unknown malignant systemic hypertension in association with bilateral ODOMS. Neuroretinitis, usually unilateral, should be differentiated from other causes of unilateral or most often bilateral ODOMS that may masquerade as neuroretinitis, mainly malignant systemic hypertension. This is essential to avoid inappropriate work-up and management and subsequent potential visual or systemic morbidity.
本研究的目的是确定被诊断为视神经视网膜炎的患者的最终诊断结果。对40例被诊断为视神经视网膜炎而转诊的伴有黄斑星芒状渗出的视盘水肿（ODOMS）患者进行了一项回顾性研究。最终诊断为视神经视网膜炎的患者有26例（65%），其中大多数患者（96.1%）为单侧受累。主要潜在病因包括猫抓病（30.8%）、立克次体病（19.2%）和特发性视神经视网膜炎（23.1%）。其余14例患者（35%）的ODOMS被误诊为视神经视网膜炎。在这些患者中，42.8%被发现患有先前未知的伴有双侧ODOMS的恶性系统性高血压。视神经视网膜炎通常为单侧，应与可能伪装成视神经视网膜炎的单侧或最常见的双侧ODOMS的其他病因相鉴别，主要是恶性系统性高血压。这对于避免不适当的检查和治疗以及随后潜在的视力或全身并发症至关重要。
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