Kahloun Rim, Ben Amor Hager, Ksiaa Imen, Zina Sourour, Jelliti Bechir, Ben Yahia Salim, Khairallah Moncef
Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, 5019, Monastir, Tunisia.
Int Ophthalmol. 2018 Feb;38(1):339-343. doi: 10.1007/s10792-016-0417-y. Epub 2016 Dec 27.
To report the results of multimodal imaging of acute outer retinitis associated to mumps infection.
A patient with mumps-associated outer retinitis evaluated by color fundus photography, spectral domain optical coherence tomography (SD-OCT), optical coherence tomography angiography, fundus autofluorescence (FAF), fluorescein angiography (FA), and indocyanine green angiography (ICGA).
We report a case of a 12-year-old boy who developed bilateral outer retinitis related to mumps. Ophthalmoscopy showed confluent areas of outer retinitis involving the posterior pole and the periphery with a centrifugal gyrate pattern. SD-OCT revealed a marked disorganization of the outer retinal layers with multiple highly reflective spicules. FA shows diffuse late hyperfluorescence with optic disk staining. ICGA shows macular and peripheral hyperfluorescent lesions with a geographical pattern in the late phases. The patient was treated with acyclovir and oral prednisone. Four weeks after presentation visual acuity remained unchanged, and retinal changes seen at the acute phase had resolved leading to extensive retinal atrophy and optic disk pallor. SD-OCT showed atrophy of the retinal pigment epithelial and outer retinal layers. FAF revealed scattered hyperautofluorescent lesions. Electrophysiology showed generalized retinal dysfunction.
Mumps infection should be considered in the differential diagnosis of bilateral necrotizing outer retinitis in children and young adults. A multimodal imaging approach may help distinguish mumps-associated retinitis from other causes of viral retinitis and facilitate appropriate management.
报告与腮腺炎感染相关的急性外层视网膜病变的多模态成像结果。
一名患有腮腺炎相关性外层视网膜病变的患者接受了彩色眼底照相、频域光学相干断层扫描（SD-OCT）、光学相干断层扫描血管造影、眼底自发荧光（FAF）、荧光素血管造影（FA）和吲哚菁绿血管造影（ICGA）检查。
我们报告了一例12岁男孩，其双侧外层视网膜病变与腮腺炎有关。检眼镜检查显示外层视网膜病变融合区域累及后极部和周边部，呈离心性回旋状分布。SD-OCT显示外层视网膜层明显紊乱，有多个高反射性针状物。FA显示弥漫性晚期高荧光伴视盘染色。ICGA显示黄斑和周边部高荧光病变，晚期呈地图状。患者接受了阿昔洛韦和口服泼尼松治疗。就诊四周后视力未变，急性期所见的视网膜改变已消退，导致广泛的视网膜萎缩和视盘苍白。SD-OCT显示视网膜色素上皮和外层视网膜层萎缩。FAF显示散在的高自发荧光病变。电生理检查显示广泛性视网膜功能障碍。
在儿童和青年双侧坏死性外层视网膜病变的鉴别诊断中应考虑腮腺炎感染。多模态成像方法可能有助于将腮腺炎相关性视网膜炎与其他病毒性视网膜炎病因区分开来，并有助于进行适当的治疗。
