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眼前节光学相干断层扫描与伪装成慢性前葡萄膜炎的残留植物性眼内异物

Anterior segment optical coherence tomography and retained vegetal intraocular foreign body masquerading as chronic anterior uveitis.

作者信息

Mahmoud Anis, Messaoud Riadh, Abid Fatma, Ksiaa Imen, Bouzayene Melek, Khairallah Moncef

机构信息

Department of Ophthalmology, Taher Sfar University Hospital, Faculty of Medicine, University of Monastir, Monastir, Tunisia.

Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir, 5019, Monastir, Tunisia.

出版信息

J Ophthalmic Inflamm Infect. 2017 Dec;7(1):13. doi: 10.1186/s12348-017-0130-7. Epub 2017 May 23.

DOI:10.1186/s12348-017-0130-7
PMID:28536985
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5442073/
Abstract

BACKGROUND

The purpose of this single case report was to report the use of anterior segment optical coherence tomography for the diagnosis and management of a retained vegetal intraocular foreign body.

RESULTS

A 23-year-old otherwise healthy male presented with a progressive vision loss in the right eye (RE). He reported a mild ocular trauma with a tree leaf 1 year ago followed by recurrent episodes of redness and pain in the RE that partially resolved after a self-medication with topical steroids. Visual acuity of the RE was limited to light perception. Slit-lamp examination of the RE showed an iris granuloma with overlying exudate and associated anterior chamber inflammatory reaction. Film X-rays, contact B-scan ultrasonography, and CT scan showed no abnormalities. Anterior segment optical coherence tomography revealed an enclaved iris foreign body. The foreign body was removed after a short course of local antibio-corticosteroid therapy. This was followed 2 months later by cataract surgery with intraocular lens implantation, with subsequent improvement of visual acuity to 20/40.

CONCLUSIONS

A missed intraocular foreign body can lead to sight-threatening complications. Anterior segment optical coherence tomography may be useful for detecting non-clinically evident intraocular foreign body involving the anterior segment masquerading as chronic anterior uveitis.

摘要

背景

本单病例报告旨在阐述眼前节光学相干断层扫描技术在诊断和处理滞留植物性眼内异物中的应用。

结果

一名23岁身体健康的男性因右眼视力进行性下降前来就诊。他自述1年前眼部曾被树叶轻微划伤，之后右眼反复出现眼红、疼痛，自行使用局部类固醇药物治疗后症状部分缓解。右眼视力仅存光感。裂隙灯检查发现右眼有虹膜肉芽肿伴上方渗出物及相关的前房炎症反应。X线平片、接触式B超及CT扫描均未发现异常。眼前节光学相干断层扫描显示有一枚包埋于虹膜的异物。经短期局部抗生素-皮质类固醇治疗后取出异物。2个月后行白内障摘除联合人工晶状体植入术，术后视力提高至20/40。

结论

眼内异物漏诊可导致威胁视力的并发症。眼前节光学相干断层扫描技术对于检测伪装成慢性前葡萄膜炎的非临床显性眼前节眼内异物可能有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97c7/5442073/c907e744c917/12348_2017_130_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97c7/5442073/4ce2bf82a5a3/12348_2017_130_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97c7/5442073/29a75be11044/12348_2017_130_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97c7/5442073/39496dfbbbdb/12348_2017_130_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97c7/5442073/e2bbb171d80a/12348_2017_130_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97c7/5442073/8a7d602de8fe/12348_2017_130_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97c7/5442073/c907e744c917/12348_2017_130_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97c7/5442073/4ce2bf82a5a3/12348_2017_130_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97c7/5442073/29a75be11044/12348_2017_130_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97c7/5442073/39496dfbbbdb/12348_2017_130_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97c7/5442073/e2bbb171d80a/12348_2017_130_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97c7/5442073/8a7d602de8fe/12348_2017_130_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97c7/5442073/c907e744c917/12348_2017_130_Fig6_HTML.jpg

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Intraocular foreign bodies: A review.眼内异物：综述
Surv Ophthalmol. 2016 Sep-Oct;61(5):582-96. doi: 10.1016/j.survophthal.2016.03.005. Epub 2016 Mar 17.
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Identification and localization of multiple intrastromal foreign bodies with anterior segment optical coherence tomography and ocular Pentacam.
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