Popiela G, Nizankowska M H, Słowik M, Koziorowska M
Katedry i Kliniki Okulistyki AM, Wrocławiu.
Klin Oczna. 1997;99(5):331-4.
A case of 44-year-old man is presented with no simultaneous bilateral posterior scleritis with amelanotic chorioidal mass initially diagnosed as intraocular tumor. The patient showed the features of nodular posterior scleritis without associated systemic disease. The case presented symptoms of severe eye pain, unilateral proptosis, hyperemia and dilatation of scleral, episcleral and conjunctival vessels. Diagnosis was made on the basis of B-scan ultrasonography. Differential diagnosis excluded melanoma malignum chorioideae, orbital cellulitis, Graves ophthalmopathy, orbital cellulitis, cavernous sinus thrombosis and carotid-cavernous fistula. The patient did not respond well to systemic steroids given in high doses and during slow tapering at the dosage of 30 mg prednisone once per day the symptom of uveal effusion syndrome occurred. After 10 months of steroid therapy the signs of disease like mild hyperemia and tenderness were still present. The adjunction of cyclosporin improved the disease and caused the remission.
本文报告一例44岁男性，无同时性双侧后巩膜炎，伴有无色素脉络膜肿物，最初被诊断为眼内肿瘤。患者表现为结节性后巩膜炎特征，无相关全身性疾病。该病例出现严重眼痛、单侧眼球突出、巩膜、巩膜上和结膜血管充血及扩张等症状。诊断基于B超检查。鉴别诊断排除了脉络膜恶性黑色素瘤、眼眶蜂窝织炎、格雷夫斯眼病、眼眶蜂窝织炎、海绵窦血栓形成和颈动脉海绵窦瘘。患者对大剂量全身性类固醇治疗反应不佳，在以每日30毫克泼尼松的剂量缓慢减量过程中出现了葡萄膜渗漏综合征症状。类固醇治疗10个月后，仍存在轻度充血和压痛等疾病体征。联合使用环孢素改善了病情并导致缓解。
