Kim Seong-Jae, Kim Che-Ron, Kim Gyu-Nam, Han Yong-Seop, Chung In-Young, Seo Seong-Wook, Park Jong-Moon, Yoo Ji-Myong
Department of Ophthalmology, College of Medicine; Gyeongsang Institute of Health Science, Gyeongsang National UniversityJinjuKorea.
Department of Ophthalmology, College of Medicine.
Neuroophthalmology. 2013 Jan 29;37(1):31-34. doi: 10.3109/01658107.2012.753912. eCollection 2013.
To report a case of invasive aspergillosis presenting as acute angle closure glaucoma. A 72-year-old male patient visited our clinic with decreased visual acuity and ocular pain on the right eye lasting for 3 d. His intraocular pressure was 42 mmHg in the right eye and 18 mmHg in the left eye. And, there was about 2 mm of exophthalmos, slight ptosis with decreased motility in all directions, conjunctival injection, moderate mydriasis with a relative afferent pupillary defect, and angle closure in the right eye. Orbital computed tomography and magenetic resonance imaging showed isotense mass involving right orbit and ethmoid sinus. Based on the biopsy, invasive aspergillosis was definitely diagnosed. Despite perfoming peripheral laser iridotomy and administrating antifungal agent and antiglaucoma medication, the patient was blinded in his right eye. During the follow-up period, visual acuity in the left eye suddenly decreased due to the invasive aspergillosis in the left paranasal sinus and optic nerve, and eventually the patient lost his left vision as well. This report is regarding a case of an invasive aspergillosis resulting in blindness in both eyes with the clinical manifestations of acute angle closure caused by invasive aspergillosis.
报告一例表现为急性闭角型青光眼的侵袭性曲霉病病例。一名72岁男性患者因右眼视力下降和眼痛持续3天前来我院就诊。右眼眼压为42 mmHg,左眼眼压为18 mmHg。右眼有大约2 mm眼球突出、轻微上睑下垂伴各方向活动度下降、结膜充血、中度瞳孔散大伴相对性传入瞳孔障碍以及房角关闭。眼眶计算机断层扫描和磁共振成像显示等密度肿块累及右眼眶和筛窦。经活检确诊为侵袭性曲霉病。尽管进行了周边激光虹膜切开术并给予抗真菌药物和抗青光眼药物治疗,患者右眼仍失明。在随访期间,左眼视力因左侧鼻窦和视神经的侵袭性曲霉病突然下降,最终患者左眼也失明。本报告是关于一例侵袭性曲霉病导致双眼失明且伴有侵袭性曲霉病引起的急性闭角型青光眼临床表现的病例。