PDF(Pubmed)
Abstract：
Neuroretinitis is a potentially vision-threatening condition distinguished by swelling of the optic disc followed by the emergence of a macular star pattern. The majority of these clinical observations are typically linked to infections caused by bacteria, parasites, or viruses. We report a case of dual infections in neuroretinitis complicated with severe macular edema. A 49-year-old lady presented with sudden onset left eye blurring of vision of one-week duration. Visual acuity was 6/6 in the right eye and 6/60 in the left eye. There was a left positive relative afferent pupillary defect with impaired optic nerve functions. A fundoscopy of the left eye showed optic disc swelling with a macular star. The right optic disc was also swollen. Vasculitis changes were observed in both posterior poles. The ocular coherence tomography of the left eye revealed the existence of macular edema, subretinal fluids, and an epiretinal membrane that extended from the optic disc to the fovea. Serological examinations were positive for toxoplasma and herpes simplex virus type 1. The patient was started on oral azithromycin, oral acyclovir, and oral corticosteroids. Left macular edema persisted despite the treatment. The patient was given a trial of a single injection of intravitreal ranibizumab. A remarkable reduction of subretinal fluids was seen post-intravitreal injection and continuation of medications. Intravitreal ranibizumab has shown significant outcomes in neuroretinitis with severe macula edema.
摘要：
神经视网膜炎是一种潜在的视力威胁疾病，其特征是视盘肿胀，随后出现黄斑星形图案。这些临床观察中的大多数通常与细菌引起的感染有关，寄生虫,或病毒。我们报告了一例神经视网膜炎并发严重黄斑水肿的双重感染。一位49岁的女士出现了一个星期的突然发作的左眼视力模糊。右眼视力为6/6，左眼为6/60。存在左阳性相对传入瞳孔缺损，视神经功能受损。左眼眼底镜检查显示视盘肿胀，黄斑星形。右视神经盘也肿了。在两个后极观察到血管炎的变化。左眼的眼相干断层扫描显示存在黄斑水肿，视网膜下液,和从视盘延伸到中央凹的视网膜前膜。血清学检查对弓形虫和单纯疱疹病毒1型呈阳性。患者开始口服阿奇霉素，口服阿昔洛韦,和口服皮质类固醇。尽管经过治疗，左侧黄斑水肿仍然存在。患者接受了单次注射玻璃体内雷珠单抗的试验。玻璃体内注射和继续药物治疗后，视网膜下液明显减少。玻璃体内雷珠单抗在患有严重黄斑水肿的视神经网膜炎中显示出显著的结果。
