IOBA (Instituto de Oftalmobiología Aplicada), Universidad Valladolid, Valladolid, Spain.
IOBA (Instituto de Oftalmobiología Aplicada), Universidad Valladolid, Valladolid, Spain.
Arch Soc Esp Oftalmol (Engl Ed). 2022 Aug;97(8):477-480. doi: 10.1016/j.oftale.2021.02.011. Epub 2022 Feb 10.
Clinical case of a 42-year-old woman who consulted for decreased vision in the left eye over two months, associated with multifocal choroiditis. Different diagnostic tests were performed to rule out infectious pathologies, as well as a diagnostic vitrectomy test, which was negative. QuantiFERON® was found to be positive and a diagnosis of serpeginous-like choroiditis (SLC) was made. Anti-tuberculosis treatment was started with worsening of vision and multifocal choroiditis. Once conventional immunotherapy and biological treatment were added, the patient presented a significant improvement in vision. To conclude, in cases of CSL, it is not only necessary to treat the infection but also the inflammatory component either with steroids or conventional immunotherapy or immunosuppression with biologics, thus reducing the number of reactivations and improving the visual prognosis.
一位 42 岁女性患者，因左眼视力下降两个月就诊，伴有多灶性脉络膜炎。进行了多种诊断测试以排除感染性疾病，以及诊断性玻璃体切除术，但均为阴性。发现 QuantiFERON®为阳性，诊断为匐行性脉络膜炎（SLC）。开始进行抗结核治疗，但视力和多灶性脉络膜炎恶化。一旦加入常规免疫疗法和生物治疗，患者的视力就会显著改善。总之，在 SLC 的情况下，不仅需要治疗感染，还需要用类固醇或常规免疫疗法或生物制剂进行免疫抑制来治疗炎症成分，从而减少复发次数并改善视力预后。
