UNASSIGNED: Case Report.
UNASSIGNED: A 32-year-old Iraqi woman with a history of Posner-Schlossman Syndrome diagnosed 10 years prior presented with blurred vision and redness in her left eye. Examination demonstrated ocular hypertension, keratic precipitates, and inflammatory cells in the anterior chamber. Quantitative real-time PCR confirmed the presence of cytomegalovirus in the aqueous humor, and dilated posterior segment examination was negative for any signs of intraocular inflammation, retinitis, or vasculitis. Her uveitis workup was otherwise negative, and she was treated with valganciclovir for 6 months. Two years after her initial presentation, she was noted to have a new vitreous hemorrhage in the left eye. Fluorescein angiography demonstrated an occlusive retinal vasculitis with extensive neovascularization without retinitis. Quantitative real-time PCR again demonstrated the presence of cytomegalovirus in the anterior chamber. Her uveitis workup was repeated, which has now returned positive for HLA-B51. She otherwise did not demonstrate any systemic signs of Behcet\'s Disease. She was restarted on valganciclovir and oral prednisone and referred to rheumatology for consideration of adalimumab initiation. Thus far she has responded very well to treatment.
UNASSIGNED: This case highlights the importance of serial posterior segment examinations and HLA-B51 testing in individuals with cytomegalovirus anterior uveitis.
■病例报告。
■一名32岁的伊拉克妇女,有波斯纳-施洛斯曼综合症病史,10年前被诊断为视力模糊,左眼发红。检查显示高眼压,角质沉淀物,和前房中的炎症细胞。定量实时PCR证实了房水中巨细胞病毒的存在,扩张的后段检查对任何眼内炎症的迹象都是阴性的,视网膜炎,或者血管炎.她的葡萄膜炎检查结果是阴性的,她接受了伐更昔洛韦治疗6个月。在她初次演讲两年后,她被发现左眼有新的玻璃体出血。荧光血管造影显示闭塞性视网膜血管炎,伴有广泛的新生血管形成,而没有视网膜炎。定量实时PCR再次证明前房中存在巨细胞病毒。她的葡萄膜炎检查重复进行,现在HLA-B51呈阳性.否则,她没有表现出任何Behcet病的全身体征。她重新开始服用伐更昔洛韦和口服泼尼松,并转诊到风湿病科考虑开始阿达木单抗。到目前为止,她对治疗反应很好。
■该病例强调了巨细胞病毒前葡萄膜炎患者进行连续后段检查和HLA-B51检测的重要性。