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Steroid-Induced Central Serous Chorioretinopathy in the Fellow Eye during the Therapeutic Course of Acute Retinal Necrosis-A Case Report
類固醇治療急性視網膜壞死誘發另一眼中心性漿液性脈絡膜視網膜症－病例報告
摘要
目的：報告一因使用類固醇治療急性視網膜壞死，而誘發另一眼中心性漿液性脈絡膜視網膜症的病例。方法：例報告。結果：一位38歲男性主訴左眼視力模糊及看到飛蚊這兩個星期之久而前來眼科門診求診。當時左眼的最佳矯正視力為二十分之六，裂隙燈下可見前葡萄膜炎及角膜內皮羊脂狀沉積。眼底檢查發現玻總體炎、周邊的視網膜有白化壞死合併血管阻塞。給予全身性抗病毒藥物Acyclovir及大量的類固醇治療後，壞死的視網膜區域大為減少且眼睛的發炎獲得改善。最佳矯正視力也回復到五分之六。然而，在治療的過程中另一眼出現中心性漿液性脈絡膜視網膜症，於是又進一步安排右眼的雷射光凝固治療。結論：使用全身性類固醇治療急性視網膜壞死的過程中，可能會誘發另一眼中心性漿液性脈絡膜視網膜症。因此在治療時我們需要密切追蹤另一眼，除了可能繼發的另一眼急性視網膜壞死外，也必須注意其他可能的視網膜病變，譬如：中心性漿液性脈絡膜視網膜症。
關鍵字
無資料並列摘要
Purpose: To report a case of steroid-induced central serous chorioretinopathy (CSCR) in the fellow eye during the course of acute retinal necrosis (ARN). Method: Interventional case report. Results: A 38-year-old male came to our clinics for blurred vision and visual floaters of the left eye for 2 weeks. The best corrected visual acuity (BCVA) was 6/20 in the left eye. Slit lamp biomicroscope finding showed anterior uveitis with mutton-fat keratic precipitates. Fundoscopy disclosed vitritis, retinal whitening with necrosis in the periphery and vascular occlusion. After systemic acyclovir and corticosteroid treatments, necrotic retina resolved as well as ocular inflammation. The BCVA improved to 6/5. However, CSCR was noted in the right eye 5 weeks after steroid treatment. The patient received further focal photocoagulation in his fellow eye. Conclusion: CSCR could occur in the fellow eye during the therapeutic course of ARN due to steroid administration. The fellow eye should be carefully examined not only for subsequent involvement of ARN, but also for the possibility of other types of retinopathy, such as CSCR.