Rabina Gilad, Amarilyo Gil, Zur Dinah, Harel Liora, Habot-Wilner Zohar
Department of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pediatric Rheumatology Unit, Schneider Children's Medical Center, Petah Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Case Rep Ophthalmol. 2020 Oct 8;11(3):516-522. doi: 10.1159/000509158. eCollection 2020 Sep-Dec.
We describe a case of Behçet's disease (BD) in a young child that presented with recurrent neuroretinitis and developed retinal lesions during follow-up. A 4.5-year-old girl presented with fever of 39.5°C, erythema nodosum in her legs, bilateral knee arthritis, and perineum aphthae. On ocular examination, visual acuity was 20/25 in both eyes. Right eye examination was normal and the left eye (LE) showed mild anterior and intermediate uveitis, normal optic disc, and a macular star appearance. Laboratory workup demonstrated elevated C-reactive protein levels, a normal abdominal ultrasound, and a normal colonoscopy. The patient was diagnosed with BD. One month post initial presentation, the patient presented with visual acuity of finger counting in the LE with significant anterior uveitis, mild intermediate uveitis, and recurrent neuroretinitis. Under treatment of IV methylprednisolone, oral betamethasone, infliximab, and colchicine, a complete systemic remission was noticed, and uveitis became quiescent. On last examination, 4.5 years post first presentation, visual acuity was 20/25 in both eyes and the LE demonstrated a remnant of a juxtafoveal retinal scar. To the best of our knowledge, this is the first case of neuroretinitis presenting as a manifestation of pediatric BD. Ophthalmologists should be aware of these unique manifestations of ocular BD.
我们描述了一例小儿白塞病（BD），该患儿最初表现为复发性神经视网膜炎，并在随访期间出现视网膜病变。一名4.5岁女孩，出现39.5°C发热、腿部结节性红斑、双侧膝关节炎和会阴部口疮。眼部检查时，双眼视力均为20/25。右眼检查正常，左眼显示轻度前部和中间葡萄膜炎、视盘正常以及黄斑星芒状外观。实验室检查显示C反应蛋白水平升高、腹部超声正常和结肠镜检查正常。该患者被诊断为BD。初次就诊后1个月，患者左眼视力降至仅能数指，伴有明显的前部葡萄膜炎、轻度中间葡萄膜炎和复发性神经视网膜炎。在接受静脉注射甲泼尼龙、口服倍他米松、英夫利昔单抗和秋水仙碱治疗后，全身症状完全缓解，葡萄膜炎也静止下来。在首次就诊4.5年后的最后一次检查中，双眼视力均为20/25，左眼可见近黄斑区视网膜瘢痕残留。据我们所知，这是首例以神经视网膜炎为表现的小儿BD。眼科医生应了解眼部BD的这些独特表现。
