Albarrak Anas Mohammad, Mohammad Yousef, Hussain Sajjad, Husain Sufia, Muayqil Taim
Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia.
Department of Internal Medicine, Neurology division, King Khalid University Hospital, Riyadh, Saudi Arabia.
BMC Ophthalmol. 2018 Dec 12;18(1):317. doi: 10.1186/s12886-018-0994-9.
This report highlights a rare case of simultaneous bilateral blindness due to posterior ischemic optic neuropathy. Typically, ophthalmic involvement in giant cell arteritis is monocular or sequential ischemia of the anterior portion of the optic nerve, and less frequently simultaneous.
An 80-year-old Saudi male came with a history of simultaneous bilateral vision loss 5 days prior to presentation. The exam showed dilated non-reactive pupils, no light perception in both eyes, and normal fundus exam. C-reactive protein and erythrocyte sedimentation rate levels were high Magnetic resonance imaging and magnetic resonance angiography of the brain showed a right posterior optic nerve lesion and absence of flow in both ophthalmic arteries respectively. A left temporal artery biopsy confirmed giant cell arteritis.
The presentation of GCA can be atypical and patients may present with simultaneous blindness. Bilateral simultaneous PION does not exclusively occur in a post surgical setting, emphasizing the importance of decreasing the threshold of suspicion of similar cases to avoid further neurological complications.
本报告重点介绍了一例罕见的因后部缺血性视神经病变导致双眼同时失明的病例。通常，巨细胞动脉炎累及眼部表现为单眼或视神经前部的序贯性缺血，双眼同时受累较少见。
一名80岁的沙特男性在就诊前5天出现双眼同时视力丧失的病史。检查发现瞳孔散大且无反应，双眼无光感，眼底检查正常。C反应蛋白和红细胞沉降率水平升高。脑部磁共振成像和磁共振血管造影分别显示右侧视神经病变和双侧眼动脉血流缺失。左侧颞动脉活检确诊为巨细胞动脉炎。
巨细胞动脉炎的表现可能不典型，患者可能出现双眼同时失明。双侧同时发生的后部缺血性视神经病变并非仅发生在手术后，强调了降低对类似病例怀疑阈值以避免进一步神经并发症的重要性。
Zotero 插件
