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诊断为伴有视乳头水肿的Arnold Chiari畸形的双侧视盘水肿的Vogt小柳原田病:眼科与神经科之间模糊的界限

Vogt Koyanagi Harada disease with bilateral disc edema diagnosed as Arnold Chiari malformation with papilledema: The blurred margin between ophthalmology and neurology.

作者信息

Agrawal Anjali, Gangwe Anil Babanrao, Singh Abhishek, Shrivastava Praher, Sushmitha S, Agrawal Deepshikha

机构信息

Vitreoretina Services, MGM Eye Institute, Raipur, Chhattisgarh, India.

Comprehensive Ophthalmology Services, MGM Eye Institute, Raipur, Chhattisgarh, India.

出版信息

Indian J Ophthalmol. 2025 Jun 1;73(6):781-785. doi: 10.4103/IJO.IJO_1891_24. Epub 2025 May 28.

Abstract

A 33-year-old male presented with bilateral, painless diminution of vision. During a previous ophthalmic consultation elsewhere, he was diagnosed with papilledema. Neuroimaging revealed an Arnold Chiari Type 1 malformation, and an urgent neurosurgical intervention was performed. Currently, ophthalmic examination revealed an anterior chamber reaction, vitritis, optic disc edema (ODE), and exudative retinal detachment in both eyes. He was clinically diagnosed with Vogt-Koyanagi-Harada disease and treated with high-dose intravenous methylprednisolone, followed by immunosuppression, resulting in a favorable visual outcome. This case highlights the need for careful ophthalmic evaluation in cases of bilateral ODE before labeling it as "papilledema."

摘要

一名33岁男性出现双侧无痛性视力减退。在之前其他地方的眼科会诊中,他被诊断为视乳头水肿。神经影像学检查显示为1型阿诺德-基亚里畸形,并进行了紧急神经外科干预。目前,眼科检查发现双眼前房反应、葡萄膜炎、视盘水肿(ODE)和渗出性视网膜脱离。他临床诊断为伏格特-小柳-原田病,并接受了大剂量静脉注射甲基强的松龙治疗,随后进行免疫抑制治疗,视力恢复良好。该病例强调了在双侧ODE病例中,在将其标记为“视乳头水肿”之前需要进行仔细的眼科评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff30/12178351/1a8c9e64bedd/IJO-73-781-g001.jpg

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