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马来西亚眼巴尔通体病的临床特征与视力预后

Clinical Profile and Visual Outcome of Ocular Bartonellosis in Malaysia.

作者信息

Tan Chai Lee, Fhun Lai Chan, Tai Evelyn Li Min, Abdul Gani Nor Hasnida, Muhammed Julieana, Tuan Jaafar Tengku Norina, Ahmad Tajudin Liza Sharmini, Wan Hitam Wan-Hazabbah

机构信息

Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.

Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia; Department of Ophthalmology, Hospital Raja Permaisuri Bainun, 30990 Ipoh, Perak, Malaysia.

出版信息

J Trop Med. 2017;2017:7946123. doi: 10.1155/2017/7946123. Epub 2017 Feb 7.

Abstract

Ocular bartonellosis can present in various ways, with variable visual outcome. There is limited data on ocular bartonellosis in Malaysia. We aim to describe the clinical presentation and visual outcome of ocular bartonellosis in Malaysia. This was a retrospective review of patients treated for ocular bartonellosis in two ophthalmology centers in Malaysia between January 2013 and December 2015. The diagnosis was based on clinical features, supported by a positive spp. serology. Of the 19 patients in our series, females were predominant (63.2%). The mean age was 29.3 years. The majority (63.2%) had unilateral involvement. Five patients (26.3%) had a history of contact with cats. Neuroretinitis was the most common presentation (62.5%). Azithromycin was the antibiotic of choice (42.1%). Concurrent systemic corticosteroids were used in approximately 60% of cases. The presenting visual acuity was worse than 6/18 in approximately 60% of eyes; on final review, 76.9% of eyes had a visual acuity better than 6/18. Ocular bartonellosis tends to present with neuroretinitis. Azithromycin is a viable option for treatment. Systemic corticosteroids may be considered in those with poor visual acuity on presentation.

摘要

眼部巴尔通体病可呈现多种表现形式,视觉预后各不相同。马来西亚关于眼部巴尔通体病的数据有限。我们旨在描述马来西亚眼部巴尔通体病的临床表现和视觉预后。这是一项对2013年1月至2015年12月期间在马来西亚两个眼科中心接受眼部巴尔通体病治疗的患者进行的回顾性研究。诊断基于临床特征,并得到巴尔通体属血清学阳性结果的支持。在我们的系列研究中的19例患者中,女性占多数(63.2%)。平均年龄为29.3岁。大多数患者(63.2%)为单侧受累。5例患者(26.3%)有接触猫的病史。神经视网膜炎是最常见的表现(62.5%)。阿奇霉素是首选抗生素(42.1%)。约60%的病例同时使用了全身性皮质类固醇。约60%的患眼初诊时视力低于6/18;在最后复查时,76.9%的患眼视力优于6/18。眼部巴尔通体病往往表现为神经视网膜炎。阿奇霉素是一种可行的治疗选择。对于初诊时视力差的患者可考虑使用全身性皮质类固醇。

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