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Takayasu 动脉炎:可能的初始表现为缺血性视网膜动脉阻塞。

Takayasu's arteritis: Ischaemic retinal arterial occlusion as a possible initial presentation.

机构信息

Licenciado en Medicina y Cirugía. Servicio de Oftalmología, Hospital Universitario Virgen del Rocío de Sevilla, Sevilla, España; Hospital Universitario Virgen del Rocío. Oftalmología, sección de Retina Quirúrgica. Sevilla, Sevilla, España.

Licenciado en Medicina y Cirugía. Servicio de Oftalmología, Hospital Universitario Virgen del Rocío de Sevilla, Sevilla, España; Hospital Juan Ramón Jiménez. Oftalmología, sección General. Huelva, Huelva, España.

出版信息

Arch Soc Esp Oftalmol (Engl Ed). 2020 Aug;95(8):400-403. doi: 10.1016/j.oftal.2020.04.016. Epub 2020 May 31.

DOI:10.1016/j.oftal.2020.04.016
PMID:32493635
Abstract

Ocular manifestations are observed in 25% of patients with Takayasu's arteritis. Its signs and symptoms can be very variable. The case is presented of a 41-year-old woman with progressive vision loss in her right eye secondary to ischaemic retinal arterial occlusion. After a systematic study, a protein purified derivative (PPD) skin test compatible with tuberculosis was found to be the only alteration. After ruling out other causes, and based on the initial suspicion of tuberculous retinal vasculitis, treatment was started with antimicrobial agents and systemic corticosteroids, without any therapeutic response. Eighteen months later, the patient developed acute kidney failure, secondary to right renal artery stenosis. The CT-angiography revealed a thickening of the aortic arch and its branches, and Takayasús arteritis was finally diagnosed. Therefore, emphasis is made on the importance of the ophthalmologist in the diagnosis of Takayasús arteritis, in which its ophthalmological manifestations can be an early sign of the disease.

摘要

25%的 Takayasu 动脉炎患者会出现眼部表现。其症状和体征可能变化多样。现报告一例 41 岁女性病例,因缺血性视网膜动脉闭塞导致右眼视力进行性下降。经过系统检查,发现唯一的改变是一种与结核病相符的蛋白纯化衍生物(PPD)皮肤试验。排除其他原因后,基于最初对结核性视网膜血管炎的怀疑,开始使用抗菌药物和全身皮质类固醇进行治疗,但没有任何治疗反应。18 个月后,患者因右肾动脉狭窄而出现急性肾衰竭。CT 血管造影显示主动脉弓及其分支增厚,最终诊断为 Takayasu 动脉炎。因此,强调眼科医生在 Takayasu 动脉炎诊断中的重要性,其眼部表现可能是疾病的早期征象。

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Takayasu's arteritis: Ischaemic retinal arterial occlusion as a possible initial presentation.Takayasu 动脉炎:可能的初始表现为缺血性视网膜动脉阻塞。
Arch Soc Esp Oftalmol (Engl Ed). 2020 Aug;95(8):400-403. doi: 10.1016/j.oftal.2020.04.016. Epub 2020 May 31.
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Posterior segment manifestations of Takayasu arteritis: A narrative review.Takayasu 动脉炎的后节段表现:叙述性综述。
Indian J Ophthalmol. 2024 May 1;72(5):637-647. doi: 10.4103/IJO.IJO_1346_23. Epub 2024 Apr 22.