结核性睫状体肉芽肿初诊为大泡性视网膜脱离：病例报告。
Tuberculous ciliary body granuloma initially diagnosed as bullous retinal detachment: a case report.
机构信息
Department of Ophthalmology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu Province, China.
Department of Ophthalmology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong Province, China.
出版信息
BMC Ophthalmol. 2024 Jun 6;24(1):236. doi: 10.1186/s12886-024-03503-9.
BACKGROUND
Ocular tuberculosis is a relatively rare extrapulmonary manifestation of tuberculosis. This vision-threatening disease is extremely challenging to diagnose, particularly because it can mimic other diseases. We report a case of tuberculous ciliary body granuloma initially diagnosed as bullous retinal detachment.
CASE REPORT
A 52-year-old female presented with bullous retinal detachment in her left eye, and ultrasound biomicroscopy (UBM) verified the presence of a lesion with ciliary body granulomatous inflammation. The T-SPOT was positive, and the purified protein derivative (PPD) test was strongly positive (diameter of 20 mm). Following the administration of oral anti-tuberculosis regimen combined with prednisone, the retina gradually became reattached, the ciliary body granuloma became significantly reduced in size, and the visual acuity of the patient noticeably improved.
CONCLUSIONS
Tuberculous ciliary body granulomas can cause bullous exudative retinal detachment and can be diagnosed with UBM. Early and full-course anti-tuberculosis treatment (ATT) combined with corticosteroid therapy can improve the patient prognosis.
背景
眼结核是一种相对罕见的肺外结核表现。这种威胁视力的疾病极难诊断，特别是因为它可能模仿其他疾病。我们报告了一例最初诊断为大疱性视网膜脱离的结核性睫状体体肉芽肿病例。
病例报告
一名 52 岁女性左眼出现大疱性视网膜脱离，超声生物显微镜（UBM）证实存在睫状体肉芽肿性炎症病变。T-SPOT 阳性，纯化蛋白衍生物（PPD）试验强阳性（直径 20 毫米）。给予口服抗结核方案联合泼尼松治疗后，视网膜逐渐复位，睫状体肉芽肿明显缩小，患者视力明显改善。
结论
结核性睫状体体肉芽肿可引起大疱性渗出性视网膜脱离，UBM 可协助诊断。早期和全程抗结核治疗（ATT）联合皮质类固醇治疗可改善患者预后。
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