Jinagal Jitender, Agarwal Aniruddha, Negi Avinash, Gupta Gaurav, Sharma Vikas, Gupta Parul Chawla, Ram Jagat
1 Advanced Eye Centre, Department of Ophthalmology, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
2 Department of Rheumatology, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
Eur J Ophthalmol. 2019 Jul;29(4):NP5-NP8. doi: 10.1177/1120672118803534. Epub 2018 Oct 7.
A 19-year-old Nepalese male presented with complaints of bilateral ocular discomfort, photophobia, watering, and redness for 1 week. Visual acuity was 6/12 and 6/60 in the right and left eye, respectively. On biomicroscopic examination, presence of peripheral stromal infiltrates with conjunctival follicles was noted; infiltrates progressed to involve central cornea with further decrease in vision over next few days. After ruling out infectious keratitis, detailed systemic examination and laboratory investigations were diagnostic of neuro-Behçet's disease. Patient responded to systemic steroidal and immunosuppressive therapy characterized by corneal healing and visual acuity improvement to 6/6 and 6/9. Although rare, but neuro-Behçet's disease can primarily present as bilateral immune keratitis and every case of bilateral keratitis needs early systemic evaluation after ruling out infective etiologies.
一名19岁的尼泊尔男性因双眼不适、畏光、流泪和眼红1周前来就诊。右眼视力为6/12，左眼视力为6/60。在生物显微镜检查中，发现周边基质浸润伴有结膜滤泡；浸润进展至累及中央角膜，随后几天视力进一步下降。在排除感染性角膜炎后，详细的全身检查和实验室检查诊断为神经白塞病。患者对全身类固醇和免疫抑制治疗有反应，表现为角膜愈合，视力提高到6/6和6/9。虽然罕见，但神经白塞病可主要表现为双侧免疫性角膜炎，每例双侧角膜炎在排除感染性病因后均需尽早进行全身评估。
