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人腺病毒:以中央视网膜血管阻塞为表现的急性视网膜坏死的不常见致病因子。

Human Adenovirus: An Unusual Causative Agent for Acute Retinal Necrosis Presented with Central Retinal Vascular Occlusion.

机构信息

Ulucanlar Eye Training and Research Hospital, University of Health Sciences , Ankara, Turkey.

出版信息

Ocul Immunol Inflamm. 2020 Jul 3;28(5):749-753. doi: 10.1080/09273948.2019.1624780. Epub 2019 Aug 14.

Abstract

PURPOSE

We describe a case of acute retinal necrosis (ARN) with central retinal vascular occlusion caused by human adenovirus (HAdV).

CASE REPORT

A 41-year-old man presented with a sudden decrease of visual acuity in his right eye since seven days. Visual acuity was hand movements and ophthalmic examination of the right eye revealed diffuse hemorrhagic retinal vasculitis with panuveitis. He was clinically diagnosed as ARN with central retinal vascular occlusion. An anterior chamber paracentesis and intravitreal ganciclovir injection were performed and intravenous ganciclovir has been initiated immediately. Polymerase chain reaction (PCR) analysis of aqueous humor identified HAdV DNA as a causative agent. Oral prednisolone was added to treatment 5 days after antiviral therapy. After 10 days of intravenous ganciclovir therapy, oral valganciclovir was given for 6 months. No recurrence or retinal detachment occurred during follow-up.

CONCLUSION

HAdV known to cause acute epibulbar infections of the eye may also cause intraocular inflammation such as ARN.

摘要

目的

我们描述了一例由人腺病毒(HAdV)引起的急性视网膜坏死(ARN)伴视网膜中央血管阻塞。

病例报告

一名 41 岁男性,右眼视力突然下降 7 天。视力为手动,右眼眼科检查显示弥漫性出血性视网膜血管炎伴全葡萄膜炎。临床诊断为ARN 伴视网膜中央血管阻塞。行前房穿刺术和玻璃体内更昔洛韦注射,并立即开始静脉注射更昔洛韦。房水聚合酶链反应(PCR)分析确定 HAdV DNA 为致病因子。抗病毒治疗 5 天后加用口服泼尼松龙。静脉注射更昔洛韦治疗 10 天后,给予口服缬更昔洛韦治疗 6 个月。随访期间无复发或视网膜脱离。

结论

已知 HAdV 可引起眼部急性眼外感染,也可引起眼内炎症,如 ARN。

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