PDF(Pubmed)
Abstract：
A 76-year-old man receiving maintenance therapy with oral steroids for immunoglobulin G4 (IgG4)-related disease presented to our hospital with the chief complaint of visual disturbance. His best corrected visual acuities of the right and left eye were 1.2 and 0.7, respectively. Humphrey visual field test revealed inferior auriculotemporal one-quarter blindness in the left eye. After detailed history-taking for IgG4-related disease, clinical diagnosis based on imaging revealed the marked pituitary/pituitary stalk enlargement with associated optic chiasm compression. Based on the history and initial evaluation findings, a diagnosis of IgG4-related ophthalmic disease was made. Intensified steroid therapy was performed, which led to symptom resolution. IgG4-related diseases are considered in the differential diagnosis when bilateral hemianopsia is observed. When unilateral visual acuity and visual field defects are present, IgG4-related diseases and other organ disorders should be considered.
摘要：
一名76岁的男子接受口服类固醇治疗免疫球蛋白G4（IgG4）相关疾病的维持治疗，以视力障碍为主要主诉。他的右眼和左眼的最佳矫正视力分别为1.2和0.7。汉弗莱视野测试显示左眼下耳颞叶四分之一失明。在详细了解IgG4相关疾病的病史后，基于影像学的临床诊断显示，明显的垂体/垂体柄增大并伴有视交叉压迫。根据历史和初步评估结果，对IgG4相关眼科疾病进行了诊断.强化类固醇治疗，这导致了症状的解决。当观察到双侧偏盲时，在鉴别诊断中考虑IgG4相关疾病。当存在单侧视力和视野缺陷时，应考虑IgG4相关疾病和其他器官疾病。
