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眼眶部偽腫瘤－病例報告
Orbital Pseudotumor-A Case Report
摘要
本篇報告一例16歲女性，初期左眼瞼紅腫，二天後，出現複視、凸眼(proptosis)而轉送至本院求治。眼科理學檢查發現，左眼上下眼瞼紅腫，內下斜視併有5mm的凸眼，電腦斷層顯示左眼上直肌及上眼瞼提肌肥大。生化免疫檢查均正常。初步診斷為眼眶偽腫瘤後，以高劑量類因醇(prednisolone 80mg/day)。口服投與治療，第二天症狀明顯改善，經過一星期後症狀完全改善，經檢查一切正常，不過仍以高劑量類固醇(prednisolone 80mg/day)持續治療至三星期。連續三星期後，劑量以每星期20mg漸減，六星期後停藥，追蹤三個月內病人無復發現象。 眼科有些不具特異性的症狀往往是有視力威脅及嚴重疾病的前兆，我們不可輕忽並要追蹤其變化以免錯失治療之良機及避免醫療糾紛。
關鍵字
無資料並列摘要
A 16-year-old girl was characterized by abrupt onset of pain, lid swelling and redness (OS), which bring her to the clinic. She initially received treatment under impression of allergic conjunctivitis. Unfortunately, the binocular diplopia and unilateral exophthalmos developed two days later. Esotropia, hypodeviation but normal color vision was also noted. Best V.A. correction was always up to 1.0. Computed tomography wit contrast enhancement revealed swelling or hypertrophy of left levator muscle and left superior rectus muscle. Lab. Tests including thyroid function test, ANA, RF, VDRL test, ESR, CBCI DC and blood sugar were all normal. High-dose oral prednisolone 80mg/day as initial dose used for 3 weeks. Patient had marked symptomatic improvement within 48 hours of starting treatment. The dosage of prednisolone was tapered by 20 mg per week. The patient was fully recovered after prednisolone treatment regiment. From the experience of this case, we learned that the non-specific symptom such as lid swelling might he the initial presentation of more serious diseases. Thus, we should carefully inspect patients at their first visit in spite of common symptoms/signs and well explain the potential risk to avoid the serious complications or even legal problems.