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单侧视盘玻璃疣误诊为视神经炎:诊断和治疗意义。

Unilateral optic disc drusen mis-diagnosed as optic neuritis: Diagnostic and therapeutic implications.

机构信息

Department of Ophthalmology, Medical School, University of Crete, Heraklion, Greece.

出版信息

Rom J Ophthalmol. 2020 Oct-Dec;64(4):449-454. doi: 10.22336/rjo.2020.69.

Abstract

To present a case of unilateral optic disc drusen, initially mis-diagnosed as optic neuritis, which led to chronic systemic administration of steroids and the development of hypercortisolism. A 22-year-old female was referred because of the lack of improvement of the manifestations of optic neuritis despite the chronic use of systemic steroids. Presence of unilateral optic disc edema was initially observed, associated with ipsilateral scotomata and increased ipsilateral latency time in visually evoked potentials (VEP). A CT scan, A and B ultrasonography and autofluorescence of the optic disc confirmed the diagnosis of optic disc drusen. In cases of optic disc edema, the possibility of drusen should always be examined even if functional disturbances, such as scotomas in visual fields or electrophysiological findings, are present, to avoid potential toxicity from unnecessary medications.

摘要

报告 1 例单侧视盘玻璃膜疣病例,最初误诊为视神经炎,导致慢性全身使用类固醇,并发生皮质醇增多症。1 名 22 岁女性因视神经炎的表现尽管长期使用全身类固醇仍未见改善而被转诊。最初观察到单侧视盘水肿,伴有同侧视野缺损和视觉诱发电位(VEP)同侧潜伏期时间延长。CT 扫描、A 超和 B 超以及视盘自发荧光检查均证实为视盘玻璃膜疣的诊断。在视盘水肿的情况下,即使存在视野中出现暗点或电生理发现等功能障碍,也应始终检查玻璃膜疣的可能性,以避免因不必要的药物而产生潜在的毒性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f14b/7739013/d0656df8a18e/RomJOphthalmol-64-449-g001.jpg

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