Fonseca Cristina, Silva Andreia Mendes, Freire Sandra, Proença Rui
Ocular Inflammation Unit, Ophthalmology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
BMJ Case Rep. 2019 Apr 4;12(4):e228717. doi: 10.1136/bcr-2018-228717.
A 17-year-old man presented to the emergency department with complaints of retro-orbital pain of the left eye and an altitudinal visual field defect for 2 weeks. Fundus examination revealed ipsilateral hyperaemic optic disc oedema, and the patient was admitted with the presumptive diagnosis of left optic neuritis. Subsequently, during follow-up, the patient developed a retinal granulomatous lesion in the superior temporal arcade with vitritis and fibrotic strands extending to the mid-periphery. Serum antibodies detection by ELISA and aqueous humour immunoblot were positive for Medical therapy with albendazole and oral steroids was instituted with satisfactory results. One year later, a new macular lesion developed with consequent vision loss.
一名17岁男性因左眼眶后疼痛和垂直性视野缺损2周就诊于急诊科。眼底检查发现同侧视盘充血水肿，该患者被诊断为左眼视神经炎并入院。随后，在随访过程中，患者颞上象限出现视网膜肉芽肿性病变，伴有玻璃体炎和延伸至周边中部的纤维化条索。通过酶联免疫吸附测定（ELISA）检测血清抗体以及房水免疫印迹法检测，结果均呈阳性。给予阿苯达唑和口服类固醇进行药物治疗，效果良好。一年后，出现了一个新的黄斑病变，导致视力丧失。
