Kanaan M Z, Lorenzi A R, Thampy N, Pandit R, Dayan Margaret
Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom.
Musculoskeletal Department, Freeman Hospital, Newcastle Upon Tyne, United Kingdom.
Neuroophthalmology. 2017 Jun 19;41(6):330-334. doi: 10.1080/01658107.2017.1328604. eCollection 2017 Dec.
A 75-year-old hypertensive female with stable idiopathic intermediate uveitis presented with bilateral sequential optic neuropathy with optic disc swelling. The optic neuropathy in the first affected eye (right) was thought to be due to non-arteritic anterior ischaemic optic neuropathy (NAION). Asymptomatic left optic disc swelling was found at routine review 2 months later, and a diagnosis of giant cell arteritis (GCA) was sought. Temporal artery duplex ultrasound showed the "halo sign," but a subsequent temporal artery biopsy showed light-chain (AL) amyloidosis with no signs of giant cell arteritis. In this case, bilateral sequential ischaemic optic neuropathy mimicking non-arteritic anterior ischaemic optic neuropathy was the presenting sign of systemic amyloidosis involving the temporal arteries.
一名75岁患有稳定型特发性中间葡萄膜炎的高血压女性，出现双侧相继性视神经病变伴视盘肿胀。第一只受影响眼睛（右眼）的视神经病变被认为是由于非动脉炎性前部缺血性视神经病变（NAION）所致。2个月后常规复查时发现无症状的左侧视盘肿胀，遂排查巨细胞动脉炎（GCA）。颞动脉双功超声显示“晕征”，但随后的颞动脉活检显示为轻链（AL）淀粉样变性，无巨细胞动脉炎迹象。在该病例中，双侧相继性缺血性视神经病变酷似非动脉炎性前部缺血性视神经病变，是累及颞动脉的系统性淀粉样变性的首发表现。
