Dr. Solomatin Eye Center, Riga, Latvia.
Rom J Ophthalmol. 2023 Apr-Jun;67(2):195-199. doi: 10.22336/rjo.2023.34.
To report the case of a 26-year-old male with bilateral Eales' disease that led to total blindness in the left eye and legal blindness in the right eye in a short time. A total clinical systemic examination, computed tomography, magnetic resonance imaging, genetic testing, and optical coherence tomography were performed in the reported case. The eye condition was managed by scatter laser treatment, Anti-VEGF injections, anterior chamber paracentesis and trabeculectomy. Non-steroidal eye drops, as well as prostaglandin analogues, beta-blockers, and carbonic anhydrase inhibitors, have been used as local treatment. Systemic treatment included an intravenous methylprednisolone course, oral corticosteroids, azathioprine, mycophenolate mofetil and a total amount of 12 Anti-VEGF injections. Despite the aggressive treatment with oral steroids, immunosuppressants, and anti-VEGF injections, there were many exacerbations, and remission was not achieved. As a result, aggressive neovascular glaucoma developed, which led to total blindness in the left eye and legal blindness in the right eye. HLA = human leukocyte antigens, Anti-VEGF = vascular endothelial growth factor inhibitors, BCVA = best corrected visual acuity, FA = fundus angiography, HBsAg = hepatitis B surface antigen, Anti-HCV = hepatitis C antibodies, TPHA = Treponema Pallidum hemagglutination assay, PCR = polymerase chain reaction, HSV = Herpes simplex virus, VZV = Varicella zoster virus, CMV = cytomegalovirus, IOP = intraocular pressure.
报告 1 例 26 岁男性双侧 Eales 病患者,在短时间内左眼完全失明,右眼法定失明。对该患者进行了全面的临床系统检查、计算机断层扫描、磁共振成像、基因检测和光学相干断层扫描。眼部病变通过散射激光治疗、抗血管内皮生长因子(VEGF)注射、前房穿刺和小梁切除术进行治疗。局部治疗采用非甾体类眼药水、前列腺素类似物、β受体阻滞剂和碳酸酐酶抑制剂。全身治疗包括静脉注射甲基强的松龙、口服皮质类固醇、硫唑嘌呤、霉酚酸酯和总共 12 次抗 VEGF 注射。尽管进行了积极的口服类固醇、免疫抑制剂和抗 VEGF 注射治疗,但仍有多次恶化,未达到缓解。结果导致严重的新生血管性青光眼,导致左眼完全失明,右眼法定失明。HLA = 人类白细胞抗原,Anti-VEGF = 血管内皮生长因子抑制剂,BCVA = 最佳矫正视力,FA = 眼底血管造影,HBsAg = 乙型肝炎表面抗原,Anti-HCV = 丙型肝炎抗体,TPHA = 梅毒螺旋体血凝试验,PCR = 聚合酶链反应,HSV = 单纯疱疹病毒,VZV = 水痘带状疱疹病毒,CMV = 巨细胞病毒,IOP = 眼内压。