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輔仁醫學期刊

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篇名 非感染性葡萄膜炎引起囊狀黃斑部水腫合併產生視神經發炎
卷期 21:4
並列篇名 The Appearance of Optic Neuritis in Non-Infectious Uveitis with Cystoid Macula Edema
作者 彭繼賢陳怡伶
頁次 029-033
關鍵字 視神經炎葡萄膜炎囊狀黃斑部水腫Optic neuritisUveitisCystoid macula edema
出刊日期 202312
DOI 10.53106/181020932023122104003

中文摘要

本文宗旨:報告一位23歲女性和41歲男性罹患非感染性葡萄膜炎,引起囊狀黃斑部水腫並合併產生視神經炎,使用口服類固醇成功治療的兩個病患。方法:回顧性病例報告。結果:病例1是23歲女性主訴雙眼模糊,雙眼呈現玻璃體炎、囊狀黃斑部水腫和視神經炎。病例2是41歲有HLA-B27陽性前房葡萄膜炎病史的男性,主訴打完COVID-19高端疫苗一天後右眼模糊,右眼呈現玻璃體炎、囊狀黃斑部水腫和視神經炎。腦部核磁共振呈現視神經顯影增加,確立視神經炎診斷。兩位病患使用局部和口服類固醇藥物後逐漸好轉,黃斑部水腫和視神經炎完全改善,6個月後追蹤沒有復發。結論:平坦部炎相關的非感染性葡萄膜炎,可以合併產生視神經炎。有可能因為相同基因例如HLA-DR15介入而造成兩者疾病。

英文摘要

Background and purpose: To report two cases with non-infectious uveitis and cystoid macular edema developing optic neuritis which were treated with oral steroid successfully in a 23-year-old female and a 41-year-old male, respectively. Methods: Retrospective case reports. Results: Case 1 was a 23-year-old lady presenting with bilateral blurred vision, and bilateral fundoscopy revealed vitritis, cystoid macular edema, and optic disc edema. Case 2 was a 41-year-old male with a history of HLA-B27 anterior uveitis complaining of right blurred vision, and vitritis, cystoid macula edema and optic disc edema were shown in his right eye. This event occurred following MVC COVID-19 vaccine 1 day. All the infectious markers including QuantiFERON-TB assay were unremarkable in both cases. Cranial MRI revealed increasing enhancement of optic nerve compatible with optic neuritis. Both cases were undergoing topical and oral steroids and uveitis resolved gradually. Cystoid macula edema and optic disc edema improved without recurrence at 6 months follow-up. Conclusions: Non-infectious uveitis such as pars planitis could occur with optic neuritis. Clinicians should be aware of these unique presentations.

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