Perone Jean Marc, Chaussard Dimitri, Hayek George
Ophthalmology Department, Regional Hospital Center of Metz-Thionville, Mercy Hospital, Metz, France.
Clin Ophthalmol. 2019 Jun 5;13:935-943. doi: 10.2147/OPTH.S167449. eCollection 2019.
The authors conducted a literature review about bilateral acute iris transillumination (BAIT) syndrome, a new and relatively unknown syndrome that should be described and made known to the greatest number to avoid potential diagnostic and therapeutic errors. The first cases date back only to 2004 and a total of 79 cases have been published to date, mainly in Europe and especially in Turkey and Belgium. It mainly affects young women between the ages of 30 and 50, and symptoms are often preceded by an upper airway infection. There is also a majority of cases where the onset of the syndrome follows oral intake of moxyfloxacin. The clinical signs are dominated by strong photophobia, secondary to a spectacular transillumination of the iris. Other classical symptoms are conjunctival infection, eye pain, blurred vision, temporary ocular hypertonia, fixed mid-dilated pupils, and pigment dispersion in the anterior chamber with pigmentary deposits in the trabecular meshwork in gonioscopy, symptoms that may be mistaken for uveitis. After a few weeks or months of evolution, persistent sequelae were pupillary atony and chronic and bilateral transillumination of the iris, leading to significant photophobia and sometimes persistent ocular hypertension. The BAIT syndrome is close to the bilateral acute depigmentation of the iris (BADI) syndrome, which is similar to BAIT but lacks associated transillumination. A few cases of patients with BAIT syndrome on one eye and BADI syndrome on the contralateral eye have been described, which confirms some form of link between the two clinical entities.
作者对双侧急性虹膜透照(BAIT)综合征进行了文献综述,这是一种新的且相对鲜为人知的综合征,应予以描述并让更多人了解,以避免潜在的诊断和治疗错误。首例病例可追溯到2004年,迄今为止共发表了79例,主要在欧洲,尤其是土耳其和比利时。它主要影响30至50岁的年轻女性,症状通常在出现上呼吸道感染之后出现。也有大多数病例显示该综合征在口服莫西沙星后发作。临床体征以强烈畏光为主,继发于虹膜显著的透照。其他典型症状包括结膜感染、眼痛、视力模糊、暂时性眼压升高、瞳孔固定中度散大以及前房色素播散,房角镜检查可见小梁网有色素沉着,这些症状可能被误诊为葡萄膜炎。经过数周或数月的发展,持续性后遗症为瞳孔无张力和虹膜慢性双侧透照,导致明显畏光,有时伴有持续性眼压升高。BAIT综合征与双侧急性虹膜色素脱失(BADI)综合征相近,后者与BAIT相似,但缺乏相关的透照表现。已有一些病例描述了一只眼为BAIT综合征而对侧眼为BADI综合征的患者,这证实了这两种临床实体之间存在某种形式的联系。