Acute multifocal placoid pigment epitheliopathy and central nervous system involvement - Nine new cases and a review of the literature
Acute multifocal placoid pigment epitheliopathy and central nervous system involvement - Nine new cases and a review of the literature
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DOI：
10.1016/s0161-6420(01)00565-6
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发表时间：
2001-05-01
期刊：
影响因子：
13.7
通讯作者：
O'Day, J
中科院分区：
文献类型：
--
作者：
O'Halloran, HS;Berger, JR;O'Day, J
目的：作者描述了9例急性多灶性片状色素上皮病（AMPPE）伴中枢神经系统（CNS）受累和永久性视力后遗症的新病例。该研究包括文献回顾和评估，管理和治疗方案的讨论。设计：回顾性，noncomparative cases series.Participants：9例患者被确定与AMPPE和中枢神经系统参与除了22例患者在literature.Main Outcome Measures：9例患者与AMPPE和中枢神经系统参与进行了审查。图表进行了审查的年龄，性别，以前的病毒profections，视力，眼科检查结果，中枢神经系统的结果，和treatment.Results：31例（9名新患者）被诊断为AMPPE和不同程度的中枢神经系统的参与。年龄8 ~ 54岁，平均27岁。确定了21名男性（68%）和10名女性（32%）。11名患者（35%）有既往病毒性疾病。视力是可变的，范围从20/20到数手指，中枢神经系统的发现范围从头痛到矢状窦thrombosis.Conclusions：急性多灶性片状色素上皮病可以与中枢神经系统异常和永久性视力缺陷。当怀疑中枢神经系统受累时，神经影像学、腰椎穿刺和脑血管造影分析提供了有用的诊断工具。在这些情况下，应考虑静脉注射皮质类固醇和与神经血管同事合作。在并发中枢神经系统动脉炎的病例中，免疫抑制剂可作为皮质类固醇的有益辅助剂。眼科学2001;108：861-868（C）2001，美国眼科学会。
Objective: The authors describe nine new cases of acute multifocal placoid pigment epitheliopathy (AMPPE) with associated central nervous system (CNS) involvement and permanent visual sequelae. The study includes a review of the literature and discussion of evaluation, management, and treatment options.Design: Retrospective, noncomparative case series.Participants: Nine patients were identified with AMPPE and CNS involvement in addition to 22 patients reviewed in the literature.Main Outcome Measures: A review of nine patients with AMPPE and CNS involvement was performed. Charts were reviewed for age, gender, preceding viral prodromes, visual acuity, ophthalmologic examination findings, CNS findings, and treatment.Results: Thirty-one patients (nine new patients) were diagnosed with AMPPE and various degrees of CNS involvement. Ages ranged from 8 to 54 years, with an average of 27 years. Twenty-one males (68%) and 10 females (32%) were identified. Eleven patients (35%) had antecedent viral illnesses. Visual acuity was variable and ranged from 20/20 to count fingers, The spectrum of CNS findings ranged from headaches to sagittal sinus thrombosis.Conclusions: Acute multifocal placoid pigment epitheliopathy can be associated with CNS abnormalities and permanent visual deficits. Neuroimaging, lumbar puncture, and cerebral angiography analysis provide useful diagnostic tools when CNS involvement is suspected. Intravenous corticosteroids and collaboration with neurovascular colleagues should be considered in these situations. in cases complicated by CNS arteritis, immunosuppressive agents can be a beneficial adjunct to corticosteroids. Ophthalmology 2001;108:861-868 (C) 2001 by the American Academy of Ophthalmology.