Symeonidis Chrysanthos, Matsou Artemis, Tzetzi Despoina, Dermenoudi Maria, Brazitikos Periklis, Mataftsi Asimina
2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Macedonia, Greece.
2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Macedonia, Greece.
J AAPOS. 2017 Dec;21(6):512-514. doi: 10.1016/j.jaapos.2017.07.218. Epub 2017 Nov 2.
A 6-year-old boy presented with unexplained unilateral low visual acuity. Best-corrected visual acuity was counting fingers in the right eye and 20/20 in the left eye. Fundus examination of the right eye revealed intermediate uveitis, with moderate vitritis, snowballs, and snowbanking. Infectious and noninfectious conditions known to be associated with intermediate uveitis were excluded. Vitreous inflammation gradually resolved with oral steroids, and amblyopia treatment with left eye patching was advised. Several months later the boy suffered acute monoarthritis and episodes of mucopurulent diarrhea; a terminal ileum biopsy was consistent with Crohn's disease. This case of Crohn's disease and uveitis is unusual in that ocular inflammation preceded intestinal involvement, with the atypical feature of chronic intermediate uveitis.
一名6岁男孩出现不明原因的单侧低视力。最佳矫正视力右眼为眼前指数,左眼为20/20。右眼眼底检查发现中间葡萄膜炎,伴有中度玻璃体炎、雪球样病变和雪堤样病变。排除了已知与中间葡萄膜炎相关的感染性和非感染性疾病。玻璃体炎症经口服类固醇逐渐消退,并建议对左眼进行遮盖治疗弱视。几个月后,该男孩患了急性单关节炎和黏液脓性腹泻;回肠末端活检结果符合克罗恩病。该例克罗恩病合并葡萄膜炎不同寻常之处在于眼部炎症先于肠道受累,并具有慢性中间葡萄膜炎的非典型特征。