双侧视盘肿胀伴脑膜炎相关的旁中央急性中浆
PARACENTRAL ACUTE MIDDLE MACULOPATHY ASSOCIATED WITH BILATERAL OPTIC DISK SWELLING AND MENINGITIS.
机构信息
Department of Ophthalmology, The University of Texas Medical Branch, Galveston, Texas.
Department of Ophthalmology, University of Washington Medicine, Seattle, Washington; and.
出版信息
Retin Cases Brief Rep. 2020 Spring;14(2):157-162. doi: 10.1097/ICB.0000000000000671.
BACKGROUND/PURPOSE: To present a novel case of paracentral acute middle maculopathy associated with bilateral optic disk swelling.
METHODS
Retrospective case report.
RESULTS
A 67-year-old woman presented with sudden onset of central vision loss and subsequent bilateral optic disk edema, retinal vessel attenuation, and anterior uveitis. Cerebrospinal fluid analysis showed signs of inflammation. Spectral domain optical coherence tomography demonstrated the pathognomonic hyperreflectivity of the middle retinal layers consistent with paracentral acute middle maculopathy. Swept-source optical coherence tomography angiography with custom vessel analysis demonstrated a 18.3% decrease in the deep retinal vascular density and 2.4 times increase in absent flow area in the affected eye compared with the fellow eye.
CONCLUSION
This case demonstrates a novel association between paracentral acute middle maculopathy and bilateral optic disk swelling secondary to central nervous system inflammation and possible infection. Although spectral domain optical coherence tomography is valuable in detecting paracentral acute middle maculopathy, optical coherence tomography angiography with vessel analysis can provide additional insight into the disease mechanism.
背景/目的：介绍一例与双侧视盘肿胀相关的新的旁中心急性中黄斑病变病例。
方法
回顾性病例报告。
结果
一位 67 岁女性出现突发性中心视力丧失，随后出现双侧视盘水肿、视网膜血管变细和前葡萄膜炎。脑脊液分析显示有炎症迹象。频域光相干断层扫描显示中视网膜层的特征性高反射性，符合旁中心急性中黄斑病变。扫频源光相干断层扫描血管造影术和自定义血管分析显示，受累眼的深层视网膜血管密度下降 18.3%，无血流区增加 2.4 倍。
结论
该病例显示，中枢神经系统炎症和可能的感染继发双侧视盘肿胀与旁中心急性中黄斑病变之间存在新的关联。尽管频域光相干断层扫描在检测旁中心急性中黄斑病变方面具有价值，但血管分析的光相干断层扫描血管造影术可以提供对疾病机制的更多了解。
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