交感性眼炎之眼底變化

本篇報告一典型交感性眼炎，觀察其一系列的視網膜及眼底螢光攝影變化。28歲男性病患右眼被一金屬碎片意外穿破眼球，五週後發生左眼交感性眼炎症狀，包括前葡萄膜炎和滲出性網膜剝離等。最初眼底的變化是後極部多發局部網膜剝離和週邊網膜之Dalen-Fuchs結節，網膜剝離漸行融合並擴大及全部網膜。最後網膜復位後顯現不規則色素變化和日落泛紅眼底(sunset glory)，並呈現特殊的網膜下色素層纖維帶。經早期大量類固醇治療，後又合併使用免疫抑制劑chlorambucil後，左眼交感眼視力挽回由初發病6/60，中間最壞時僅辨指數，最後回復到6/6，右眼激發眼則由於網膜增殖性病變視力只餘光覺。追蹤迄今一年，病情穩定無再發。本報告揭示交感性眼炎引起視力減退的直接原因在於滲出性視網膜剝離，在發病的各個時期中顯現不同的多樣化之眼底變化，早期正確診斷和適切的治療可以避免嚴重的合併症而保存相當良好的視力。

關鍵字

無資料

並列摘要

We report serial fundus changes of sympathetic ophthalmia in the left eye of a 28-year-old male which occurred 5 weeks following the penetrating injury of right globe with IOFB retention. The onset of sympathetic ophthalmia was one week after the pars plana vitrectomy with IOFB removal. The initial fundus change was the presence of multifocal serous detachments at the posterior pole and Dalen-Fuchs nodule at the peripheral fundus. As the detachment progressed, the area extended to the whole retina with the highest elevation in the lower half forming a bullous detachment. Finally the neurosensory retina sealed down, while the retinal pigment epithelium demonstrated severe destruction with characteristic sunset glory and moth-eaten appearance. Successful treatment was achieved with the megadose steroid and immunosuppressive therapy (chlorambucil). The visual acuity at onset was 6/60, worsened to only counting finger in the fulminant stage, and recovered to the final 6/6. The follow up period was one year. The clinical pictures and fluorescein angiograms are presented. The pathogenesis of fundus change in sympathetic ophthalmia is discussed.

並列關鍵字

Sympathetic ophthalmia ； Exudative retinal detachment

國際替代計量

交感性眼炎之眼底變化

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