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疑似结核性葡萄膜炎中的视网膜下积脓:两例报告

Subretinal Hypopyon in Presumed Tubercular Uveitis: A Report of Two Cases.

作者信息

Chawla Rohan, Tripathy Koushik, Meena Seema, Behera Aswini Kumar

机构信息

Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Middle East Afr J Ophthalmol. 2018 Jul-Dec;25(3-4):163-166. doi: 10.4103/meajo.MEAJO_187_17.

Abstract

Subretinal hypopyon is an uncommon entity which has been described in ocular infections and inflammations including endophthalmitis, acute retinal necrosis, and sympathetic ophthalmia. The authors report subretinal hypopyon in two cases of presumed tubercular uveitis which responded well to antitubercular therapy (ATT). The first case was a 47-year-old male with bilateral peripapillary chorioretinitis with a subretinal hypopyon. Tuberculosis was confirmed on biopsy of a cervical lymph node which revealed acid-fast bacilli. Case 2 was a 17-year-old male with unilateral involvement in the form of a choroidal granuloma with disc edema and retinitis. In addition, a subretinal hypopyon was evident. Both these cases showed dramatic anatomical improvement with ATT. A novel finding of subretinal hypopyon is described in these cases of presumed ocular tuberculosis. It may be prudent to start empirical ATT early on detection of a subretinal hypopyon along with other manifestations compatible with tubercular etiology.

摘要

视网膜下积脓是一种罕见的病症,在包括眼内炎、急性视网膜坏死和交感性眼炎等眼部感染和炎症中已有描述。作者报告了两例疑似结核性葡萄膜炎病例出现视网膜下积脓,这两例对抗结核治疗(ATT)反应良好。第一例是一名47岁男性,双侧视乳头周围脉络膜视网膜炎伴视网膜下积脓。经颈部淋巴结活检证实为结核病,发现抗酸杆菌。病例2是一名17岁男性,以脉络膜肉芽肿伴视盘水肿和视网膜炎的形式单侧受累。此外,视网膜下积脓明显。这两例经抗结核治疗后均显示出显著的解剖学改善。在这些疑似眼部结核病例中描述了视网膜下积脓这一新颖发现。在检测到视网膜下积脓以及其他与结核病因相符的表现时,尽早开始经验性抗结核治疗可能是谨慎的做法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0324/6348936/f5076f59f1ad/MEAJO-25-163-g001.jpg

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