Unilateral Purtscher-Like Retinopathy Associated with Possible Systemic Lupus Erythematosus-A Case Report

疑似紅斑性狼瘡併發單側Purtscher-like視網膜病變－病例報告

唐浚恩(Chun-En Tang) ； 鄭成國(Cheng-Kuo Cheng)

《中華民國眼科醫學會雜誌》 49卷1期 (2010/03) Pp. 60-67

https://doi.org/10.30048/ACTASOS.201003.0009

摘要

目的：報告一個紅斑性狼瘡引起之單側Purtscher-like視網膜病變。
方法：回溯性觀察臨床病例報告。
結果：一位40歲男性主訴為突發性左眼視力模糊伴隨眼前灰色斑塊病灶，至門診就診時，其最佳矯正視力左眼為6/60，右眼為6/6。眼底檢查發現左眼視網膜後極部有多處點狀出血以及棉花－羊毛斑，右眼則無異常。在沒有外傷撞擊的情狀下，我們高度懷疑是由於自體免疫疾病所引起的。病人之血壓以及血糖值皆在正常範圍之內，因此排除糖尿病及高血壓視網膜病變之診斷，根據病人之臨床症狀以及血液生化免疫檢查，共符合11項紅斑性狼瘡診斷標準中之2項，因此風濕免疫科醫師診斷為“可能性紅斑性狼瘡”。在給予口服類固醇3個月後，病人左眼最佳矯正視力從6/60進步至6/12。
結論：雖然非常少見，單側Purtscher-like視網膜病變仍有可能由全身系統性疾病如紅斑性狼瘡所引起。

並列摘要

Purpose: To report an unusual case of unilateral Purtscher-like retinopathy in a patient with possible systemic lupus erythematosus (SLE).
Method: Retrospective case report.
Case report: A 40-year-old male complained of sudden gray patches in front of his left eye for 1 week. His best corrected visual acuity was 6/6 in his right eye (OD) and 6/60 in his left eye (OS). Fundus examination showed dot and blot hemorrhages as well as multiple cotton-wool spots in the posterior pole (OS). In the absence of trauma, these symptoms led us to autoimmune disease. Although not completely compatible with the criteria, high titer of ANA, positive Anti-ENA RNP, and equivocal Anti-ENA Sm strongly suggest the diagnosis of ”possible” SLE. A steroid treatment was given with fair visual response.
Conclusion: Although rare, unilateral Purtscher-like retinopathy may still be related to autoimmune disease such as SLE.

並列關鍵字

Purtscher's retinopathy ； Purtscher-like retinopathy ； lupus retinopathy