Cao X S, Wang H, Peng X Y
Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2020 Aug 25;100(32):2498-2502. doi: 10.3760/cma.j.cn112137-20200426-01323.
To investigate the clinical features of patients with biopsy-proven sarcoid uveitis. The clinical data of the patients with biopsy-proven sarcoid uveitis who consulted the Ophthalmic Clinic of Beijing Tongren Hospital from February 2012 to February 2020 was retrospectively reviewed and analyzed. All the patients underwent visual acuity test, slit lamp microscopy, indirect ophthalmoscopy, fundus fluorescein angiography (FFA), chest computed tomography (CT) and other auxiliary examinations. A total of 9 patients (18 eyes) (6 females, 3 males) with biopsy-proven sarcoid uveitis were included in the study, with a mean age of (52.6±9.0) years. Based on the modified Scadding classification, there were 2 and 7 cases of Stage Ⅰ and Ⅱ sarcoidosis, respectively. The ocular symptoms were the initial presenting complaints in 6 patients, who had a time from onset to diagnosis of 9.0 (2.6, 20.3) months. Three patients had a history of sarcoidosis. Fever was reported in 2 patients, fatigue in 3 patients, body weight loss in 3 patients, respiratory problems in 5 patients, with bilateral ocular involvement in all the patients. Among the 18 eyes, panuveitis occurred in 10 eyes, posterior uveitis in 4 eyes, anterior uveitis in 4 eyes, mutton fat keratic precipitates (KP) in 10 eyes, granular KP or no obvious KP in 8 eyes, posterior synechia of the iris in 9 eyes, cataract in 8 eyes, inflammatory vitreous opacity in 8 eyes, macular edema in 7 eyes, epiretinal membrane in 6 eyes, retinal vasculitis in 2 eyes, glaucoma in 2 eyes, and optic disc granuloma in 2 eye. Among the 13 eyes whose peripheral ocular fundus was visible, multiple chorioretinal peripheral lesions were found in 5 eyes. Chest CT should be performed in the uveitis patients with older age, female gender, bilateral ocular involvement, the symptom of fever, body weight loss and respiratory problems in time to exclude the sarcoid uveitis. Sarcoid uveitis may presents with granular KP or no obvious KP, and the posterior segment of the eye ball was the most commonly involved area.
探讨经活检证实的结节病性葡萄膜炎患者的临床特征。回顾性分析2012年2月至2020年2月在北京同仁医院眼科门诊就诊的经活检证实的结节病性葡萄膜炎患者的临床资料。所有患者均接受了视力检查、裂隙灯显微镜检查、间接检眼镜检查、眼底荧光血管造影(FFA)、胸部计算机断层扫描(CT)等辅助检查。本研究共纳入9例(18只眼)经活检证实的结节病性葡萄膜炎患者(女性6例,男性3例),平均年龄(52.6±9.0)岁。根据改良的Scadding分类,Ⅰ期和Ⅱ期结节病分别有2例和7例。6例患者以眼部症状为首发主诉,从发病到诊断的时间为9.0(2.6,20.3)个月。3例患者有结节病史。2例患者有发热,3例患者有乏力,3例患者有体重减轻,5例患者有呼吸问题,所有患者均为双眼受累。18只眼中,全葡萄膜炎10只眼,后葡萄膜炎4只眼,前葡萄膜炎4只眼,羊脂状角膜后沉着物(KP)10只眼,颗粒状KP或无明显KP 8只眼,虹膜后粘连9只眼,白内障8只眼,炎性玻璃体混浊8只眼,黄斑水肿7只眼,视网膜前膜6只眼,视网膜血管炎2只眼,青光眼2只眼,视盘肉芽肿2只眼。在13只可见周边眼底的眼中,5只眼发现多发脉络膜视网膜周边病变。对于年龄较大、女性、双眼受累、有发热、体重减轻及呼吸问题症状的葡萄膜炎患者,应及时行胸部CT检查以排除结节病性葡萄膜炎。结节病性葡萄膜炎可表现为颗粒状KP或无明显KP,眼球后段是最常受累的部位。