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Refractory Orbital Pseudotumor Treated Successfully by Posteriorly Intraorbital Injection of Triamcinolone Acetonide-A Case Report
以眼窩後注射Triamcinolone Acetonide成功治療難處理的眼窩偽腫瘤－病例報告
摘要
目的：報告一個以後眼窩注射Triamcinolone Acetonide成功治療難治療的眼窩部偽腫瘤病例。 方法：病例報告。 結果：一位25歲女性左眼視力模糊約4個月。左眼最佳矯正視力為20/400，並有色彩覺受損及相對性瞳孔傳入障礙，腦部CT及MRI表現為一左眼眼窩尖端腫塊。經診斷為眼窩部偽腫瘤所造成之視神經病變，她接受了三天類固醇脈衝治療，左眼視力在兩天內有戲劇性的改善(20/16)。然而，當類固醇減量時，視力再度下降，更出現了月亮臉、水牛肩等類固醇造成的副作用。我們以後眼窩注射40mg/lmL Triamcinolone Acetonide來取代全身性類固醇，病人左眼視力回到20/20，而全身倒頃固醇造成的副作用也減少了。 結論：當病人對類固醇反應很好卻產生嚴重的全身性副作用時，後眼窩注射類固醇可為有效的替代性治療。
關鍵字
無資料並列摘要
Purpose: To report a case of refractory orbital pseudotumor which was successfully treated by posteriorly intraorbital injection of Triamcinolone Acetonide. Method: A case report. Results: A 25-year-old female complained of painfully blurred vision in her left eye for 4 months. The best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/400 in the left eye. Impaired color vision and relatively afferent pupillary defect in the left eye were also noted. Brain CT and MRI revealed a left orbital apex mass lesion. Under the impression of optic neuropathy caused by orbital pseudotumor, she received methylprednisolone pulse therapy for 3 days. Her visual acuity improved dramatically from 20/400 to 20/16 in the left eye within 2 days. However, her vision deteriorated whenever the oral steroid dosage was tapered. Moreover, obvious moon face, buffalo hump, the red striae of the legs and trunk related to systemic steroids were noted. Therefore posteriorly intraorbital injection of Triamcinolone acetonide 40 mg/1mL was performed in her left eye in place of the use of systemic steroid. Her BCVA finally improved to 20/20 at last. The steroid side effects ceased after ending systemic steroid use. Conclusion: Posteriorly intraorbital injection of steroids may be an alternative treatment for patients who have good response to systemic steroids but are intolerant to the related adverse reactions.
延伸閱讀
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