Department of Uvea and Vitreo Retina, Aravind Eye Hospital, Puducherry, India.
Indian J Ophthalmol. 2018 Jun;66(6):866-868. doi: 10.4103/ijo.IJO_954_17.
Bilateral uveal effusion syndrome associated with bilateral acute retinal necrosis is a diagnostic and therapeutic challenge. A 52 year old man presented with bilateral angle closure with choroidal detachment. With restricted fundus view, parenteral steroid was started. During close follow up bilateral discrete areas of peripheral retinitis were noted. Parenteral steroids were promptly stopped and parenteral antivirals with oral steroids were continued. It showed healing response with nil recurrences till last follow up. Aggressive treatment of bilateral uveal effusion with parenteral steroids can cause progression of bilateral acute retinal necrosis leading to phthisis bulbi. However early diagnosis, prompt intervention and close follow up are the key elements to therapeutic success even during diagnostic surprises and avoid costly mistakes.
双侧葡萄膜渗出综合征伴双侧急性视网膜坏死是一个诊断和治疗的挑战。一名 52 岁男性因双眼闭角型青光眼伴脉络膜脱离就诊。由于眼底检查受限,开始给予全身皮质类固醇治疗。密切随访时发现双侧周边视网膜出现离散的局灶性区域。全身皮质类固醇立即停用,改为全身抗病毒治疗联合口服皮质类固醇。治疗后反应良好,无复发,直至最后一次随访。全身皮质类固醇治疗双侧葡萄膜渗出综合征可能导致双侧急性视网膜坏死进展,导致眼球萎缩。然而,早期诊断、及时干预和密切随访是治疗成功的关键因素,即使在诊断中出现意外情况,也可以避免代价高昂的错误。