Rishi Ekta, Rishi Pukhraj
Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India.
GMS Ophthalmol Cases. 2018 Feb 22;8:Doc02. doi: 10.3205/oc000084. eCollection 2018.
A19-year-old man presented with decreased vision in the right eye following a bee sting injury, ten days back. Examination revealed conjunctival hyperemia at the site of the sting, anterior uveitis, vitritis, mild disc hyperemia, ocular hypotony, and striae at macula. Treatment was initiated elsewhere with topical antibiotics, steroid, and cycloplegic. Systemic steroids were added. Three weeks later, vitiritis resolved, intraocular pressure became normal and the vision improved from 20/60 to 20/20. However, a chorioretinal atrophy in the vicinity of the sting site was noted. Global electroretinogram (ERG) revealed reduced scotopic responses and depressed oscillatory potentials; even though the photopic response was normal. Multifocal ERG and microperimetry were normal. Two months later, after discontinuation of medication, a traumatic mydriasis with a sluggish pupillary reaction was noted. Sixteen months later, the fundus remained stable. This is a rare case report of a bee sting injury leading to anterior uveitis, vitritis, and cilio-choroidal detachment, mimicking endophthalmitis. Timely recognition of the cause of the intraocular inflammation and appropriate treatment led to optimal recovery.
一名19岁男性在10天前被蜜蜂蜇伤后出现右眼视力下降。检查发现蜇伤部位结膜充血、前葡萄膜炎、玻璃体炎、轻度视盘充血、眼压降低以及黄斑部条纹。患者在其他地方开始接受局部抗生素、类固醇和睫状肌麻痹剂治疗，并加用了全身类固醇。三周后，玻璃体炎消退，眼压恢复正常，视力从20/60提高到20/20。然而，在蜇伤部位附近发现了脉络膜视网膜萎缩。全视野视网膜电图（ERG）显示暗视反应降低和振荡电位降低；尽管明视反应正常。多焦ERG和微视野检查正常。两个月后，停药后发现外伤性瞳孔散大伴瞳孔反应迟钝。16个月后，眼底情况保持稳定。这是一例罕见的蜜蜂蜇伤导致前葡萄膜炎、玻璃体炎和睫状体脉络膜脱离的病例报告，类似眼内炎。及时识别眼内炎症的病因并进行适当治疗可实现最佳恢复。
