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WOW世界眼科新时讯之英文原文病
文章来源：视网膜静脉周围炎 发布时间:2016-11-17 11:14:49 点击数： 次
WOW系列之《世界眼科新时讯》
年第六期：英文病例报道摘录/CaseReport
MULTIFOCALRETINALINFILTRATESWITHPHLEBITISANDOPTICNEUROPATHYINANHIV-POSITIVEPEDIATRICPATIENT
CaseReport
A15-year-oldboyfromZimbabwe,Africa,withnosignificantmedicalhistorypresentedwitha7-dayhistoryofblurredvisionintherighteye.Hisvisualacuitywas20/intherighteyeand20/20intheleft.Noafferentpupillarydefectwasnoted.Anteriorsegmentexaminationdemonstratedmildanteriorvitreousinflammationineacheye.Posteriorsegmentexaminationrevealedbilateral,multiple,andwhiteintraretinalinfiltratesandsegmentalphlebitis,seenmostprominentlyinthesuperonasalquadrantofeacheye(Figure1).Ageographicareaofdisruptionoftheretinalpigmentepitheliumwasalsonotedintheposteriorpoleontheleft.
Spectraldomainopticalcoherencetomographywasnormalintherighteyeandshowedsubtleirregularitiesoftheouterretinalhyperreflectivebandsintheleftmacula.Fundusautofluorescenceoftheposteriorpolewasunremarkableintherighteyeanddemonstratedmottledhypoautofluorescenceintheleftmacula.Afluoresceinangiogramshowedmottledhyperfluorescenceintheareaofretinalpigmentepitheliumdisruptionontheleftandfaintretinalvascularleakageinthesuperonasalperipheryofeacheye(Figure1).Anautomatedvisualfielddemonstratedamildcecocentralscotomaintherighteyeandscatterednonspecificdefectsintheleft.Anextensiveinitiallaboratoryevaluationwasnotableforamarkedlyelevatederythrocytesedimentationrateof90mm/hourandamildlyreducedhematocritbutwasotherwiseunremarkableincludingnegativetestingforsyphilis(RPRandTPPA)andtuberculosis(IGRA).Chestx-rayandmagneticresonanceimagingofthebrainandorbitswerenormal.HIVtestingwasthenfoundtobepositiveandconfirmedbyWesternblotanalysis.TheCD4+T-cellcountwas/μL.
Thepatientreturned1weeklaterwithspontaneouslyrecoveredvisionto20/20ineacheye.Tendayslater,hepresentedwith北京治疗白癜风的最好医院北京那里有好的白癜风医院
