巩膜下嵌入性异物,类似结节性前巩膜炎。
Embedded Episcleral Foreign Body Mimicking Nodular Anterior Scleritis.
机构信息
Dokuz Eylul University Faculty of Medicine, Department of Ophthalmology, İzmir, Türkiye.
Dokuz Eylul University Faculty of Medicine, Department of Pathology, İzmir, Türkiye.
出版信息
Turk J Ophthalmol. 2024 Feb 22;54(1):46-48. doi: 10.4274/tjo.galenos.2023.37460.
A 56-year-old man was referred to our clinic for unilateral nodular scleritis unresponsive to systemic corticosteroids. A localized, nodular hyperemia on the nasal bulbar conjunctiva surrounding a central cyst-like lesion together with vascular engorgement was observed on slit-lamp examination of the left eye. No abnormal fundoscopic findings were noted. Surgical exploration revealed an embedded episcleral brown colored, soft to touch, splinter-like organic foreign body (FB) which was confirmed by the histopathological examination. Nodular hyperemia resolved during the postoperative follow-up period, and mild scar tissue accompanied by scleral thinning developed in the left nasal bulbar conjunctiva. Ocular injury associated with FBs may cause significant ocular morbidity depending on the nature and location of the FB. Severe visual disability may occur if left untreated. Subconjunctival FBs are rare and may present with a clinical picture mimicking episcleritis or scleritis. History of trauma involving a FB should always be assessed for an accurate differential diagnosis and appropriate management of patients with anterior scleritis.
一位 56 岁男性因单侧结节性巩膜炎,对全身皮质类固醇治疗反应不佳,被转诊至我科就诊。左眼裂隙灯检查发现,球结膜鼻侧局部结节性充血,围绕中央囊性病变,伴有血管充盈。眼底检查未见异常。手术探查发现巩膜表面有一个嵌入性的棕褐色、触诊柔软、呈碎片样的异物(FB),组织病理学检查证实了这一点。术后随访期间,结节性充血消退,左眼鼻侧球结膜出现轻度瘢痕组织,伴有巩膜变薄。FB 引起的眼球损伤可能会导致严重的眼部疾病,具体取决于 FB 的性质和位置。如果不治疗,可能会导致严重的视力障碍。结膜下 FB 较为罕见,其临床表现可能类似于巩膜炎或表层巩膜炎。对于有 FB 相关外伤史的患者,应始终评估病史,以进行准确的鉴别诊断,并对前巩膜炎患者进行适当的管理。