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伴有两个不同脉络膜新生血管膜的单侧Vogt-小柳-原田病:病例报告

Unilateral Vogt-Koyanagi-Harada Disease With Two Distinct Choroidal Neovascular Membranes: A Case Report.

作者信息

Mathew Raeba, Murugavel Boopathy

机构信息

Ophthalmology, Canadian Specialist Hospital, Dubai, ARE.

Ophthalmology, Aster Hospital, Al Qusais, Dubai, ARE.

出版信息

Cureus. 2024 Aug 7;16(8):e66405. doi: 10.7759/cureus.66405. eCollection 2024 Aug.

DOI:10.7759/cureus.66405
PMID:39246872
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11380649/
Abstract

Vogt-Koyanagi-Harada (VKH) disease is a multisystem inflammatory disease that usually presents with bilateral panuveitis. Unilateral manifestations of VKH, albeit rare, have been described. Choroidal neovascularization may occur as a complication during the disease. Reactivation of uveitis may also occur during treatment. A patient with unilateral features of VKH disease presented with two distinct types of choroidal neovascular membranes and two episodes of reactivation of posterior uveitis. He underwent treatment with a combination of systemic steroids/immunosuppressive agents, intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents, and dexamethasone implants with good clinical response.  Patients with VKH disease need to be diagnosed early, treated adequately with a combination of systemic and ocular medication, and followed up diligently for any complication that may arise, to optimize visual acuity.

摘要

伏格特-小柳-原田(VKH)病是一种多系统炎症性疾病,通常表现为双侧全葡萄膜炎。VKH的单侧表现虽然罕见,但也有相关描述。脉络膜新生血管可能作为该病的一种并发症出现。在治疗期间也可能发生葡萄膜炎复发。一名具有VKH病单侧特征的患者出现了两种不同类型的脉络膜新生血管膜以及两次后葡萄膜炎复发。他接受了全身类固醇/免疫抑制剂、玻璃体内抗血管内皮生长因子(抗VEGF)药物以及地塞米松植入物联合治疗,临床反应良好。VKH病患者需要早期诊断,采用全身和眼部药物联合进行充分治疗,并对可能出现的任何并发症进行密切随访,以优化视力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ce/11380649/f5b1bccedd40/cureus-0016-00000066405-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ce/11380649/95c9d585c89f/cureus-0016-00000066405-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ce/11380649/f5b1bccedd40/cureus-0016-00000066405-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ce/11380649/95c9d585c89f/cureus-0016-00000066405-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ce/11380649/f5b1bccedd40/cureus-0016-00000066405-i02.jpg

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本文引用的文献

1
Inflammatory Choroidal Neovascular Membranes: Clinical Profile, Treatment Effectiveness, and Visual Prognosis.炎症性脉络膜新生血管膜:临床特征、治疗效果及视力预后
J Ophthalmol. 2021 Jul 23;2021:9982883. doi: 10.1155/2021/9982883. eCollection 2021.
2
Vogt-Koyanagi-Harada disease is always bilateral: reports of unilateral cases failed to use choroidal investigations showing subclinical involvement of the fellow eye.原田病总是双侧性的:单侧病例的报告未能采用脉络膜检查,而这些检查显示对侧眼存在亚临床受累情况。
J Ophthalmic Inflamm Infect. 2021 Feb 9;11(1):6. doi: 10.1186/s12348-021-00237-3.
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Outcomes of Intravitreal Bevacizumab in Choroidal Neovascularization in Vogt-Koyanagi-Harada Disease- A Prospective Study.
玻璃体内注射贝伐单抗治疗 Vogt-小柳原田病脉络膜新生血管的前瞻性研究。
Ocul Immunol Inflamm. 2021 Apr 3;29(3):572-578. doi: 10.1080/09273948.2019.1687731. Epub 2019 Nov 20.
4
An update on inflammatory choroidal neovascularization: epidemiology, multimodal imaging, and management.炎症性脉络膜新生血管的最新进展:流行病学、多模态成像及治疗
J Ophthalmic Inflamm Infect. 2018 Sep 12;8(1):13. doi: 10.1186/s12348-018-0155-6.
5
EFFICACY AND SAFETY OF RANIBIZUMAB FOR THE TREATMENT OF CHOROIDAL NEOVASCULARIZATION DUE TO UNCOMMON CAUSE: Twelve-Month Results of the MINERVA Study.雷珠单抗治疗不常见病因所致脉络膜新生血管的疗效和安全性:MINERVA 研究的 12 个月结果。
Retina. 2018 Aug;38(8):1464-1477. doi: 10.1097/IAE.0000000000001744.
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Inflammatory choroidal neovascularization in Indian eyes: Etiology, clinical features, and outcomes to anti-vascular endothelial growth factor.印度人群眼中的炎症性脉络膜新生血管:病因、临床特征及抗血管内皮生长因子治疗的效果
Indian J Ophthalmol. 2017 Apr;65(4):295-300. doi: 10.4103/ijo.IJO_262_16.
7
Adalimumab Treatment in Patients with Vogt-Koyanagi-Harada Disease.阿达木单抗治疗 Vogt-小柳原田病患者。
Ocul Immunol Inflamm. 2018;26(3):485-489. doi: 10.1080/09273948.2016.1236969. Epub 2016 Oct 24.
8
Posterior subtenon triamcinolone acetonide injection as a primary treatment in eyes with acute Vogt-Koyanagi-Harada disease.后Tenon囊下注射曲安奈德作为急性Vogt-小柳-原田病眼部的主要治疗方法。
Br J Ophthalmol. 2015 Sep;99(9):1211-4. doi: 10.1136/bjophthalmol-2014-306244. Epub 2015 Mar 19.
9
Bilateral dexamethasone intravitreal implant in a young patient with Vogt-Koyanagi-Harada disease and refractory uveitis.双侧地塞米松玻璃体内植入术用于一名患有Vogt-小柳-原田病和难治性葡萄膜炎的年轻患者。
Clin Rheumatol. 2015 Jun;34(6):1145-8. doi: 10.1007/s10067-014-2623-1. Epub 2014 Apr 25.
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Clin Ophthalmol. 2012;6:1233-7. doi: 10.2147/OPTH.S34294. Epub 2012 Aug 1.