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单侧盘状水肿性 AZOOR:不典型病例报告。

AZOOR with unilateral disc edema: An atypical case report.

机构信息

Department of Ophthalmology, Centro Hospitalar Vila Nova de Gaia/Espinho Vila Nova de Gaia, Portugal.

Department of Ophthalmology, Centro Hospitalar Vila Nova de Gaia/Espinho Vila Nova de Gaia, Portugal.

出版信息

Arch Soc Esp Oftalmol (Engl Ed). 2023 Aug;98(8):473-477. doi: 10.1016/j.oftale.2023.03.009. Epub 2023 May 27.

Abstract

Acute zonal occult outer retinopathy (AZOOR) diagnosis is challenging and frequently delayed. Atypical findings were described, nevertheless optic disc edema has not been consistently reported. In this study we pretend to describe a challenging diagnosis of AZOOR. In our case, a 19-year-old female presented painless vision loss in her right eye for 2 weeks. Fundus examination revealed optic disc hyperaemic edema and the visual field (VF) an enlarged blind spot. Non-infectious optic neuritis was assumed and intravenous corticotherapy administered. Four months later, VA had improved, but a VF defect persisted. Funduscopic examination showed mild peripapillary atrophy and autofluorescence zonal hyperautofluorescence around optic disc. Optical coherence tomography demonstrated diffuse loss of outer retinal layers and electroretinogram weakened signal at the corresponding region. In conclusion, unilateral optic disc edema, generally not associated with AZOOR typical presentation, hamper an early diagnosis and expresses this case relevance.

摘要

急性区域性隐匿性外层视网膜病变(AZOOR)的诊断具有挑战性,且常被延误。尽管已有描述非典型表现,但视盘水肿并未得到一致报告。在本研究中,我们拟描述一个具有挑战性的 AZOOR 诊断病例。在我们的病例中,一名 19 岁女性因右眼无痛性视力丧失就诊,病程已达 2 周。眼底检查显示视盘充血性水肿,视野出现扩大的盲点。考虑非感染性视神经炎,并给予静脉皮质激素治疗。4 个月后,视力有所改善,但视野缺损仍存在。眼底检查显示轻微的视盘周围萎缩和视盘周围自发荧光呈带状高荧光。光学相干断层扫描显示外视网膜层弥漫性丧失,视网膜电图在相应区域信号减弱。总之,单侧视盘水肿,通常与 AZOOR 的典型表现不相关,妨碍了早期诊断,并凸显了该病例的重要性。

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