METHODS: A 31-year-old male patient complained of redness in the right eye with decreased visual acuity for 3 days. Ocular examination revealed a milky white clouding of the right anterior chamber of the eye. Two clusters of yellowish-white exudates were visible on the surface of the iris in the upper nasal and temporal areas in addition to elevated intraocular pressure. He had a previous diagnosis of type 2 diabetes mellitus (T2DM). Laboratory tests suggested hyperlipidemia and ketoacidosis. After admission, topical glucocorticoids, mydriasis, and intraocular pressure-lowering drugs combined with hypoglycemic and lipid-lowering therapy and fluid replacement therapy were given immediately. After 10 days of treatment, the uveitis and systemic condition of the right eye were effectively controlled and improved.
CONCLUSIONS: Abnormal glucose and lipid metabolism leads to impairment of the blood-aqueous barrier, which causes a severe uveitis response in the anterior chamber. After the use of topical steroids and mydriatic eye drops combined with systemic hypoglycemic and lipid-lowering interventions, the condition was significantly relieved.
方法:一名31岁男性患者主诉右眼红肿,视力下降3天。眼部检查显示右前房乳白色混浊。除了眼内压升高外,在上鼻和颞部区域的虹膜表面上还可以看到两簇黄白色渗出物。他以前诊断为2型糖尿病(T2DM)。实验室检查提示高脂血症和酮症酸中毒。入院后,局部糖皮质激素,散瞳,立即给予降眼压药物联合降糖降脂治疗和补液治疗。治疗10天后,右眼葡萄膜炎和全身状况得到有效控制和改善。
结论:糖脂代谢异常导致血水屏障受损,导致前房严重的葡萄膜炎反应。在使用局部类固醇和散瞳滴眼液联合全身降糖降脂干预后,病情明显缓解。