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弥漫性单侧亚急性神经视网膜炎:诊断与管理中的挑战

Diffuse Unilateral Subacute Neuroretinitis: Challenges in Diagnosis and Management.

作者信息

Nurul-Farhana Mustafa, Roslin-Azni Abdul Aziz, Sor-Earn Tan, Shatriah Ismail, Shelina Oli Mohamed

机构信息

Department of Ophthalmology and Visual Sciences, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, MYS.

Department of Ophthalmology, Hospital Shah Alam, Shah Alam, MYS.

出版信息

Cureus. 2024 Apr 18;16(4):e58510. doi: 10.7759/cureus.58510. eCollection 2024 Apr.

DOI:10.7759/cureus.58510
PMID:38765355
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11101984/
Abstract

We report two cases of diffuse unilateral subacute neuroretinitis (DUSN) where multimodal imaging was used to assist in locating the nematode. The first case presented with clusters of migrating choroiditis with a suspicious tiny visualized worm noted on serial fundus photography. The second case had an atypical presentation with extensive exudative retinal detachment and a suspicious coiled worm in the subretinal space noted on optical coherence tomography. Both cases received oral albendazole for six weeks while the first case received additional argon laser photocoagulation to the suspected nematode. Both cases showed resolution of the ocular inflammation upon completion of treatment with no further recurrences. DUSN should be suspected in young and healthy patients with unexplained unilateral inflammatory eye disease with severe loss of vision. This series highlights the challenges faced in identifying the nematode in cases with suspected DUSN.

摘要

我们报告了两例弥漫性单侧亚急性神经视网膜炎(DUSN)病例,其中使用多模态成像来协助定位线虫。第一例表现为成群的迁移性脉络膜炎,在系列眼底照相中发现一条可疑的微小可见虫体。第二例表现不典型,有广泛的渗出性视网膜脱离,光学相干断层扫描显示视网膜下间隙有一条可疑的盘绕虫体。两例均接受口服阿苯达唑六周,第一例还对可疑线虫进行了氩激光光凝治疗。两例在治疗完成后眼部炎症均消退,未再复发。对于原因不明的单侧炎症性眼病且视力严重丧失的年轻健康患者,应怀疑患有DUSN。本系列病例突出了疑似DUSN病例中线虫识别所面临的挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73f4/11101984/3f47ce905709/cureus-0016-00000058510-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73f4/11101984/ee15429029d0/cureus-0016-00000058510-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73f4/11101984/2b04d330a66f/cureus-0016-00000058510-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73f4/11101984/3f47ce905709/cureus-0016-00000058510-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73f4/11101984/ee15429029d0/cureus-0016-00000058510-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73f4/11101984/2b04d330a66f/cureus-0016-00000058510-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73f4/11101984/3f47ce905709/cureus-0016-00000058510-i03.jpg

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本文引用的文献

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Am J Ophthalmol Case Rep. 2021 May 12;23:101112. doi: 10.1016/j.ajoc.2021.101112. eCollection 2021 Sep.
2
Short-term oral albendazole therapy for diffuse unilateral subacute neuroretinitis: A case report.短期口服阿苯达唑治疗弥漫性单侧亚急性神经视网膜炎:一例报告。
Am J Ophthalmol Case Rep. 2021 Mar 6;22:101054. doi: 10.1016/j.ajoc.2021.101054. eCollection 2021 Jun.
3
Multimodal imaging-guided diagnosis, management and follow-up of a case of diffuse unilateral subacute neuroretinitis.
一例弥漫性单侧亚急性神经视网膜炎的多模态成像引导诊断、管理及随访
BMJ Case Rep. 2020 Apr 15;13(4):e234737. doi: 10.1136/bcr-2020-234737.
4
Diffuse unilateral subacute neuroretinitis: review article.弥漫性单侧亚急性神经视网膜炎:综述文章
J Ophthalmic Inflamm Infect. 2019 Dec 27;9(1):23. doi: 10.1186/s12348-019-0191-x.
5
Diffuse Unilateral Subacute Neuroretinitis Evolving With Submacular Granuloma.弥漫性单侧亚急性神经视网膜炎伴黄斑部肉芽肿进展。
Ocul Immunol Inflamm. 2021 Jan 2;29(1):90-94. doi: 10.1080/09273948.2019.1662921. Epub 2019 Oct 24.
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