Abraham Sharanya, Sudharshan S, Bhende Muna, Ganesh Sudha K, Gopal Sriram
Sankara Nethralaya, Chennai, Tamil Nadu, India.
Athreya Retinal Centre, Trichy, Tamil Nadu, India.
Indian J Ophthalmol. 2017 May;65(5):416-420. doi: 10.4103/ijo.IJO_838_16.
A young female presented with bilateral subacute onset of progressive decrease in night vision and reduced peripheral field of vision. The short duration and rapid progression of symptoms along with the lack of family history of night blindness prompted a diagnosis of autoimmune retinopathy (AIR). Fundus fluorescein angiography, optical coherence tomography, visual fields, and electroretinogram were suggestive of AIR. A differential diagnosis of retinitis pigmentosa (RP) was also made. Antiretinal autoantibodies were detected in the blood sample. Treatment was with oral steroids and subsequently oral immunosuppressive agents. Visual acuity was maintained, fundus examination reverted to normal, and investigations repeated at every visit were stable with improvement in visual fields. Our case suggests that AIR, if diagnosed early and treated appropriately, may have a good outcome and should be considered in patients with an atypical presentation of RP.
一名年轻女性出现双侧亚急性起病的进行性夜视力下降和周边视野缩小。症状持续时间短且进展迅速,同时缺乏夜盲家族史,提示诊断为自身免疫性视网膜病变(AIR)。眼底荧光血管造影、光学相干断层扫描、视野检查和视网膜电图均提示AIR。还进行了色素性视网膜炎(RP)的鉴别诊断。血液样本中检测到抗视网膜自身抗体。治疗采用口服类固醇,随后口服免疫抑制剂。视力得以维持,眼底检查恢复正常,每次复诊时重复的检查结果稳定,视野有所改善。我们的病例表明,AIR若能早期诊断并得到适当治疗,可能会有良好的预后,对于表现不典型的RP患者应考虑这一疾病。