Arnavaz A B, Freissler K, Lang G E
Universitäts-Augenklinik und Poliklinik, Ulm.
Ophthalmologe. 1997 Aug;94(8):595-9. doi: 10.1007/s003470050166.
Wegener's granulomatosis is a focal necrotizing granulomatous vasculitis of unknown etiology. It manifests initially as localized inflammation, usually of the lungs, and preceeds to the state of generalisation which can be life-threatening due to renal failure. Ocular and orbital involvement occurs in 28-58% of patients with Wegener's granulomatosis. More often, the anterior segments of the eye are involved whereas inflammation of the posterior segments is quite uncommon.
We report a case of posterior scleritis as the initial manifestation of Wegener's granulomatosis in a 65-year-old woman.
Posterior scleritis responded favourably to therapy with systemic steroids and cyclophosphamide.
Wegener's granulomatosis can have a poor prognosis if not diagnosed and treated in time. Knowledge of posterior scleritis as a possible presenting symptom may therefore facilitate early diagnosis and treatment and prevent progression of the disease.
韦格纳肉芽肿是一种病因不明的局灶性坏死性肉芽肿性血管炎。它最初表现为局部炎症,通常发生在肺部,随后发展为全身性病变,可因肾衰竭而危及生命。28% - 58%的韦格纳肉芽肿患者会出现眼部和眼眶受累。更常见的是眼前段受累,而后段炎症则相当少见。
我们报告一例65岁女性以巩膜后炎为首发表现的韦格纳肉芽肿病例。
巩膜后炎经全身用类固醇和环磷酰胺治疗后反应良好。
韦格纳肉芽肿若不及时诊断和治疗,预后可能较差。因此,了解巩膜后炎可能作为首发症状有助于早期诊断和治疗,预防疾病进展。