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肉芽肿性多血管炎致浆液性视网膜脱离的眼部表现:病例报告。

Ocular Manifestation of Granulomatosis with Polyangiitis Presenting as Serous Retinal Detachment: A Case Report.

机构信息

Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul 02447, Republic of Korea.

出版信息

Medicina (Kaunas). 2024 Oct 15;60(10):1690. doi: 10.3390/medicina60101690.

Abstract

: Ocular involvement is relatively common in granulomatosis with polyangiitis (GPA); however, choroidal involvement is rare. We present a case of serous retinal detachment resulting from choroidal involvement in GPA. : A 55-year-old male presented to our clinic with bilateral eye redness and pain. Ocular examination revealed bilateral conjunctival injection, and dilation of the episcleral and scleral vessels. Slit-lamp examination revealed anterior chamber cells. Optical coherence tomography (OCT) confirmed serous retinal detachment (SRD) in the left eye. The patient had recently been diagnosed with GPA following a lung biopsy and had received immunosuppressive therapy, including systemic steroids, cyclosporine, mycophenolate mofetil, and rituximab. Five weeks after treatment, the clinical symptoms of the patient, including SRD, improved with alleviation of systemic symptoms. However, tapering systemic steroids and immunosuppressants and discontinuing rituximab led to disease reactivation. OCT demonstrated a recurrence of subretinal fluid, which had previously resolved, and slit-lamp examination showed mild bilateral engorged scleral vessels. : Choroidal involvement can present as SRD and may indicate disease activity in patients with GPA.

摘要

眼部受累在肉芽肿伴多血管炎(GPA)中相对常见;然而,脉络膜受累却很少见。我们报告了一例 GPA 导致的脉络膜受累引起的浆液性视网膜脱离病例。

一名 55 岁男性因双眼眼红和疼痛到我院就诊。眼部检查显示双侧结膜充血,并且伴有表层巩膜血管和巩膜血管扩张。裂隙灯检查显示前房细胞。光学相干断层扫描(OCT)证实左眼存在浆液性视网膜脱离(SRD)。该患者最近在接受肺部活检后被诊断为 GPA,并接受了免疫抑制治疗,包括全身皮质类固醇、环孢素、霉酚酸酯和利妥昔单抗。治疗 5 周后,患者的临床症状(包括 SRD)随着全身症状的缓解而改善。然而,逐渐减少全身皮质类固醇和免疫抑制剂并停用利妥昔单抗导致疾病复发。OCT 显示先前已解决的视网膜下液再次出现,裂隙灯检查显示双侧轻度表层巩膜血管充血。

脉络膜受累可表现为 SRD,并且可能表明 GPA 患者的疾病活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7a3/11509864/2ff6f5dac5a6/medicina-60-01690-g001.jpg

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