伪装成自身免疫性视网膜病变的疑似眼结核
Presumed Ocular tuberculosis masquerading as autoimmune retinopathy.
作者信息
Hou Si-Meng, Liu Qian, Zhang Xiao-Hui, Peng Xiao-Yan, Zeng Hui-Yang
机构信息
Department of Retina, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
Beijing Key Laboratory of Ophthalmology & Visual Science, Beijing, China.
出版信息
Am J Ophthalmol Case Rep. 2025 Mar 5;38:102296. doi: 10.1016/j.ajoc.2025.102296. eCollection 2025 Jun.
PURPOSE
To report a case of tuberculosis (TB) infection with an unusual posterior segment manifestation that mimicked autoimmune retinopathy (AIR).
OBSERVATION
A 36-year-old male presented with blurred vision and constriction of visual field (VF) in both eyes for over 2 weeks. Multimodal imaging suggested he had AIR-like retinopathy; however, the initial local/systemic steroid treatment worsened his condition. He later tested positive for TB infection and received one month of anti-tuberculosis (ATT) monotherapy, followed by combined steroid treatment for an additional 5 months. He was followed up 12 months after treatment, demonstrating significantly improved visual function and restoration of macular anatomy.
CONCLUSIONS
This case underscores the need to consider intraocular TB as a potential mimic of AIR, highlighting the importance of ruling out active infections before diagnosing AIR.
目的
报告一例结核病（TB）感染病例，其具有不寻常的后段表现，酷似自身免疫性视网膜病变（AIR）。
观察结果
一名36岁男性出现双眼视力模糊和视野（VF）缩小超过2周。多模态成像提示他患有类似AIR的视网膜病变；然而，最初的局部/全身类固醇治疗使他的病情恶化。他后来结核感染检测呈阳性，并接受了一个月的抗结核（ATT）单一疗法，随后联合类固醇治疗又持续了5个月。治疗后对他进行了12个月的随访，结果显示视觉功能显著改善，黄斑解剖结构恢复。
结论
该病例强调了将眼内结核视为AIR潜在模仿者的必要性，突出了在诊断AIR之前排除活动性感染的重要性。
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