Department of Ophthalmology, Zunyi First People's Hospital, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China.
Zunyi Medical University, Zunyi, China.
Eur J Ophthalmol. 2024 Mar;34(2):NP92-NP97. doi: 10.1177/11206721231203262. Epub 2023 Sep 18.
Panuveitis is a serious inflammatory disease. Setae are fibers produced by many insects and plants. Many case reports have described caterpillar and spider fibers entering the eye. These hairs are covered with tiny barbs that help them enter and migrate into the eye tissue, leading to severe inflammation. Normally, they are buried mainly in the conjunctiva and cornea. However, in the present case, they entered the posterior segment of the eye, which is very rare.
A female patient presented with a complaint of repeated foreign body sensation, redness, pain, and photophobia in the left eye for 9 years following initial exposure to caterpillars. She visited the doctor in January after aggravation of symptoms. Slit-lamp examination, ultrasound biomicroscopy, ultrasound B-scan, fluorescein angiography, and indocyanine green angiography revealed the presence of a foreign body in the vitreous, which caused discomfort in the patient's left eye and subsequently, panuveitis of the left eye. The symptoms improved significantly after foreign body removal using vitrectomy. Microscopic examination revealed that the foreign body was caterpillar setae.
Clinicians should be more vigilant about history of contact with caterpillars while examining uveitis that has recurred for many years. Identification of the root cause of the disease can ensure better treatment.
全葡萄膜炎是一种严重的炎症性疾病。刚毛是许多昆虫和植物产生的纤维。许多病例报告描述了毛毛虫和蜘蛛的纤维进入眼睛。这些毛发上覆盖着微小的倒刺,帮助它们进入并迁移到眼组织中,导致严重的炎症。正常情况下,它们主要埋在结膜和角膜中。然而,在本例中,它们进入了眼睛的后节,这非常罕见。
一名女性患者左眼曾接触过毛毛虫,9 年来反复出现异物感、眼红、眼痛和畏光,1 年前症状加重后来就诊。裂隙灯检查、超声生物显微镜检查、超声 B 型扫描、荧光素血管造影和吲哚青绿血管造影显示玻璃体内有异物,导致患者左眼不适,随后左眼全葡萄膜炎。经玻璃体切除术取出异物后,症状明显改善。显微镜检查显示异物为毛毛虫刚毛。
在检查反复发作多年的葡萄膜炎时,临床医生应更加警惕接触毛毛虫的病史。确定疾病的根本原因可以确保更好的治疗。