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感染 COVID-19 后立即出现点状脉络膜内病变:病例报告。

Punctate inner choroidopathy immediately after COVID-19 infection: a case report.

机构信息

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Shogoin Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan.

出版信息

BMC Ophthalmol. 2022 Jul 7;22(1):297. doi: 10.1186/s12886-022-02514-8.

Abstract

BACKGROUND

Punctate inner choroidopathy (PIC) is a rare idiopathic inflammatory multifocal chorioretinopathy. Although the etiology of PIC is unknown, it is proposed to be an autoimmune disease that arises in the context of polygenic susceptibility triggered by an environmental stimulus, such as infection. We reported a case of PIC immediately after COVID-19 infection.

CASE PRESENTATION

A 25-year-old woman complained of blurred vision in the right eye six days after the symptoms of COVID-19 infection first appeared. The patient visited our hospital and underwent comprehensive ophthalmological examination 18 days after the initial COVID-19 symptoms. Based on the characteristic fundus features observed with multimodal imaging, retinal specialists made a diagnosis of PIC. The patient was affected with high myopia. As her general COVID-19 symptoms disappeared, the patient was prescribed oral prednisolone 30 mg/day for 14 days to treat PIC. Fundus abnormality decreased and her ocular symptoms improved. No side effects were observed, including the recurrence of general COVID-19 symptoms.

CONCLUSION

We experienced an extremely rare case of PIC immediately after COVID-19 infection and showed the potential safety and effectiveness of oral prednisolone in treating PIC in the active phase after the disappearance of the general COVID-19 infection symptoms.

摘要

背景

点状内层脉络膜病变(PIC)是一种罕见的特发性炎症性多灶性脉络膜视网膜病变。虽然 PIC 的病因尚不清楚,但据推测是一种自身免疫性疾病,在多基因易感性的背景下,由感染等环境刺激引发。我们报告了一例 COVID-19 感染后即刻发生的 PIC 病例。

病例介绍

一位 25 岁女性,在 COVID-19 感染症状出现后 6 天出现右眼视力模糊。患者来我院就诊,在首次 COVID-19 症状出现后 18 天接受了全面眼科检查。基于多模态成像观察到的特征性眼底特征,视网膜专家诊断为 PIC。患者患有高度近视。由于患者的一般 COVID-19 症状已消失,给予患者口服泼尼松龙 30mg/天,共 14 天,以治疗 PIC。眼底异常减轻,眼部症状改善。未观察到任何副作用,包括一般 COVID-19 症状的复发。

结论

我们在 COVID-19 感染后即刻经历了一例极其罕见的 PIC 病例,并显示了在一般 COVID-19 感染症状消失后,口服泼尼松龙在 PIC 活动期治疗中的潜在安全性和有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f06/9260973/b8f17374ab93/12886_2022_2514_Fig1_HTML.jpg

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