Rare Association of Perivascular Granulomatous Lesions in a Patient with Acute Retinal Necrosis.
Rare Association of Perivascular Granulomatous Lesions in a Patient with Acute Retinal Necrosis.
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DOI：
10.1159/000442084
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发表时间：
2015-09
影响因子：
0.4
通讯作者：
Nishida K
中科院分区：
文献类型：
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作者：
Sogawa T;Hashida N;Sawa M;Nishida K
本研究的目的是检查急性视网膜坏死（ARN）血管周围肉芽肿性病变的连续变化。一名健康的46岁日本女性，她的左眼出现飞蚊症和疼痛，接受了光学相干断层扫描（OCT）、荧光素血管造影和常规眼科检查。使用频域（SD）-OCT监测血管周围肉芽肿性病变的治疗相关变化。患者无既往眼科病史，一般状况良好。裂隙灯检查显示左眼角膜沉淀物和房水细胞（2+）。眼底检查显示颞上区黄白色坏死性视网膜病变、视网膜动脉炎、视网膜出血和玻璃体混浊。根据诊断标准，患者被诊断为ARN。SD-OCT图像证实了血管周围区域和中央凹的高强度和均匀肉芽肿沉积。开始全身皮质类固醇和抗病毒治疗，导致肉芽肿病变逐渐消退。患者继续随访未治疗，无复发、视网膜脱离或活动性炎症的证据。这是第一次报告血管周围肉芽肿性病变的病人与ARN。我们的研究结果表明，肉芽肿的形成可能会导致在视网膜的ARN患者没有暴发性炎症。
The aim of this study was to examine sequential changes in perivascular granulomatous lesions with acute retinal necrosis (ARN). A healthy 46-year-old Japanese woman, who developed floaters and pain in her left eye, underwent optical coherence tomography (OCT), fluorescein angiography, and routine ophthalmological examinations. Treatment-associated changes in perivascular granulomatous lesions were monitored using spectral-domain (SD)-OCT. The patient had no previous ophthalmic history, and her general condition was good. A slit-lamp examination revealed keratic precipitates and aqueous cells (2+) in the left eye. A fundus examination showed yellow-white patches of necrotizing retinal lesions in the temporal upper area, retinal arteritis, retinal hemorrhage, and vitreous opacities. The patient was diagnosed with ARN according to diagnostic criteria. SD-OCT images confirmed high-intensity and uniform granulomatous deposits in the perivascular area and fovea. Systemic corticosteroids and antiviral therapy were initiated, resulting in the gradual resolution of granulomatous lesions. The patient continues to be followed untreated without evidence of recurrence, retinal detachment, or active inflammation. This is the first report of perivascular granulomatous lesions in a patient with ARN. Our results showed that the formation of granulomas may be induced in the retina of ARN patients without fulminant inflammation.