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結核性脈絡膜視網膜炎所引起的非裂孔性視網膜剝離－1病例報告
Non-Rhegmatogenous Retinal Detachment Caused by Tuberculous Chorioretinitis-One Case Report
摘要
一位47歲的男病人因左眼突發性之視力降低以及視野缺損而住院；其眼底所見包括非裂孔性之視網膜剝離以及黃白色結節狀沉積物。胸部愛克斯光以及其他實驗診斷方面的檢查顯示出結核病之證據，而眼底螢光攝影可以見到脈絡膜視網膜炎以及視神經乳頭炎之病灶。該病人以抗結核藥物治療二週後，其左眼上方眼底急性發作之視網膜剝離部分已服貼回去，三個月後完全癒合，矯正視力進步到零點貳。
關鍵字
無資料並列摘要
A 47-year-old man was seen on January 7, 1983 with complaints of loss of the upper visual field in the left eye for 3 months and a central scotoma in the right eye for 20 years. The vision was 0.4 (0.6X+1.25D) in the left eye and finger counting in the right eye. The anterior segments of both eyes were nothing particular. Vitreous cavities were clear. In the left eye the retina was detached in the lower half. A yellowish grey round lession, sized 1/2 P. D. was noted inferiotemporally to the macular. There was no retinal break. In three days the vision of the left eye rapidly decreased to hand movement showing total bullous detachment of the retina. In the right eye, there were proliferative macular lesion and localized flat detachment of the retina in the lower temporal vicinity of the macula. Laboratory examination was non contributory. Chest X-ray film showed increase of lung markings with a diagnosis of minimal lung tuberculosis. The PPD skin test showed a 12 mm erythema. The pictures of chorioretinitis and optic neuritis can be found in the fluorescein angiography. Antituberculous treatment with neoiscotin, streptomycin and rifampin was initated on January 10. Markedly effective response to the treatment was obtained. The freshly detached retina of the upper half resettled down two weeks after the initiation of the antituberculous treatment. In May 13, the detachment in both eyes completely reattached. The corrected vision of both eyes were 0.2.