ocular inflammation

眼部炎症
  • 文章类型: Case Reports
    背景:霍奇金淋巴瘤(HL)是引起眼部炎症的极为罕见的原因,通常在葡萄膜炎和其他眼部疾病的典型检查中不考虑。先前报道了一些眼部炎症病例,这些病例显示HL在出现时没有典型的HL症状。认识到与HL相关的潜在眼部炎症可以促使眼科医生扩大诊断方法,并与内科部门合作研究这种罕见但重要的病因。
    方法:一名17岁的白人妇女出现单侧全葡萄膜炎,后来被诊断为HL。眼部表现为非坏死性巩膜炎,前葡萄膜炎,玻璃体炎,白色/淡黄色脉络膜视网膜病变,乳头炎和血管炎。左锁骨上淋巴结活检证实诊断为结节硬化性霍奇金淋巴瘤IIB期。排除葡萄膜炎的其他原因。化疗导致疾病缓解,眼部病变变得静止,并伴有持续的色素性脉络膜视网膜疤痕。
    结论:霍奇金淋巴瘤在鉴别诊断中应该考虑偶尔可以通过单侧眼部炎症来发现的疾病。一个全面的,多学科方法是正确评估此类案件的关键。
    BACKGROUND: Hodgkin\'s lymphoma (HL) is an extremely rare cause of ocular inflammation that is usually not considered in the typical workup of uveitis and other eye diseases. A few cases of ocular inflammation were reported previously showcasing HL with absence of typical symptoms of HL at presentation. Acknowledging the potential ocular inflammation associated with HL can prompt ophthalmologists to broaden their diagnostic approach and collaborate with internal medicine departments to investigate this rare yet significant etiology.
    METHODS: A 17-year-old Caucasian woman presenting unilateral panuveitis was later diagnosed with HL. The ocular findings were non-necrotizing scleritis, anterior uveitis, vitritis, white/yellowish chorioretinal lesions, papillitis and vasculitis. A left supra-clavicular lymph node biopsy confirmed the diagnosis of nodular sclerosing Hodgkin\'s lymphoma stage IIB. Other causes of uveitis were excluded. Chemotherapy led to remission of the disease and the ocular lesions became quiescent with persistent pigmented chorioretinal scars.
    CONCLUSIONS: Hodgkin\'s lymphoma should be considered in the differential diagnosis of diseases that can occasionally be revealed by unilateral ocular inflammation. A comprehensive, multidisciplinary approach is key to properly assessing such cases.
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  • 文章类型: Journal Article
    背景:蝎子毒害,农村地区普遍存在的医疗紧急情况,由于其潜在的严重性,需要立即关注。虽然眼部表现并不常见,它们会导致严重的并发症,如角膜溃疡。我们提出了一个独特的角膜溃疡病例,随后黄色蝎子(Hemiscorpiuslepturus)在眼睛附近刺痛,以前没有记录的场景。
    方法:一名34岁的男性在蝎子叮咬后寻求医疗护理,尽管之前有抗毒治疗。临床检查显示明显的眼部炎症,角膜基质融化,和前房炎症,与假单胞菌属感染的微生物学确认。治疗包括强化头孢他啶和万古霉素滴眼液,除了外用皮质类固醇,导致视觉和角膜愈合。
    结论:这个案例突出了解决蝎毒的紧迫性及其可能导致严重眼部并发症的可能性,包括角膜溃疡.及时诊断和抗生素和皮质类固醇的靶向治疗对于良好的预后至关重要。全面了解和及时干预蝎伤引起的眼部表现对于在这种情况下最佳的患者管理和结果至关重要。
    BACKGROUND: Scorpion envenomation, a prevalent medical emergency in rural areas, demands immediate attention due to its potential severity. While ocular manifestations are uncommon, they can lead to significant complications such as corneal ulceration. We present a unique case of corneal ulceration subsequent to a yellow scorpion (Hemiscorpius lepturus) sting near the eye, a scenario not previously documented.
    METHODS: A 34-year-old male sought medical care following a scorpion sting despite prior anti-venom treatment. Clinical examination revealed pronounced ocular inflammation, corneal stromal melting, and anterior chamber inflammation, with microbiological confirmation of Pseudomonas spp infection. Treatment comprised fortified ceftazidime and vancomycin eye drops, alongside topical corticosteroids, leading to visual and corneal healing.
    CONCLUSIONS: This case highlights the urgency of addressing scorpion envenomation and its potential for severe ocular complications, including corneal ulceration. Prompt diagnosis and targeted therapy with antibiotics and corticosteroids are crucial for favorable outcomes. A comprehensive understanding and timely intervention in scorpion sting-induced ocular manifestations are essential for optimal patient management and outcomes in such cases.
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  • 文章类型: Case Reports
    背景:眼内炎症在前段或后段手术后很常见。它们通常表现为前段或后段的非感染性炎症,称为毒性前段或后段综合征(TPSS),或无菌或感染性眼内炎。在这份报告中,我们描述了玻璃体视网膜手术后TPSS的罕见病例,表现为出血性视网膜血管炎。
    方法:一名58岁男性,诊断为左眼急性孔源性视网膜脱离,在出现的同一天,进行了一次平坦平坦部玻璃体切除术,并进行了硅油内填充。在介绍时,没有眼内炎症的迹象,他在受影响的眼睛的视力是20/200。
    结果:在术后第一天,视网膜与硅油很好地附着。沿着视网膜下周边,观察到出血性闭塞性血管炎。临床检查显示,沿着视网膜表面的下颞侧象限保留了眼内棉纤维。除了标准的术后药物,开始一个疗程的全身性类固醇(40mg/天泼尼松龙片剂).术后第一周结束时,出血性视网膜血管炎的临床症状开始消退,在术后第四个星期结束时,他们已经完全解决了。
    结论:本报告描述了玻璃体视网膜手术后TPSS的异常诊断,很可能是由于眼内棉纤维的存在。后段的这种过度炎症通常响应于局部和全身性类固醇的过程。
    BACKGROUND: Intraocular inflammation is common after anterior or posterior segment surgery. They typically manifest either as non-infectious inflammation of the anterior or posterior segment, known as toxic anterior or posterior segment syndrome (TPSS), or as sterile or infective endophthalmitis. In this report, we describe a rare case of TPSS following vitreoretinal surgery, presenting as hemorrhagic retinal vasculitis.
    METHODS: A 58-year-old male diagnosed with a left eye acute rhegmatogenous retinal detachment underwent an uneventful primary pars plana vitrectomy with silicone oil endotamponade on the same day of presentation. At presentation, there were no signs of intraocular inflammation, and his visual acuity in the affected eye was 20/200.
    RESULTS: The retina was well-attached with silicone oil in place on the first post-operative day. Along the inferior retinal periphery, a hemorrhagic occlusive vasculitis was observed. Clinical examination revealed retained intraocular cotton fiber along the inferotemporal quadrant over the retinal surface. In addition to the standard post-operative medications, a course of systemic steroids (40 mg per day of Prednisolone tablets) was started. At the end of the first post-operative week, clinical signs of hemorrhagic retinal vasculitis were beginning to resolve, and by the end of the fourth post-operative week, they had completely resolved.
    CONCLUSIONS: This report describes an unusual diagnosis of TPSS after vitreoretinal surgery, most likely due to the presence of an intraocular cotton fiber. This excessive inflammation of the posterior segment usually responds to a course of topical and systemic steroids.
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  • 文章类型: Case Reports
    巩膜炎是巩膜和巩膜组织的炎症,其特征是在浅层和深层巩膜血管中注射。当只累及巩膜组织时,它被称为上巩膜炎。外巩膜炎主要是特发性的,但可能继发于潜在的风湿病。尽管罕见,药物相关性上巩膜炎和巩膜炎也应纳入鉴别诊断.肿瘤坏死因子-α(TNF-α)抑制剂通常具有良好的耐受性,但是依那西普,特别是,有可能引起矛盾的不良反应,包括眼部炎症,比如葡萄膜炎,巩膜炎,和眼肌炎。依那西普的作用机制与其他TNF-α抑制剂不同,因为它充当诱饵受体,这可能部分解释了更频繁报道的依那西普相关眼部炎症。依那西普也可能对预防眼部炎症无效。然而,去激发和再激发现象已证明依那西普与新发眼部炎症之间存在因果关系.我们报告了一例15岁男孩,患有附着性炎相关的关节炎和家族性地中海热,该男孩在接受依那西普治疗时出现上巩膜炎和眼睑炎,随后表现出去激发和再激发反应。因此,医师还应意识到,上巩膜炎应被认为是依那西普的自相矛盾的不良反应,并且可能发生在儿科患者中.我们还回顾了英文文献,以提供概述和评估干预方案。
    Scleritis is an inflammation of the episcleral and scleral tissues, characterized by injection in both superficial and deep episcleral vessels. When only episcleral tissue is involved, it is referred to as episcleritis. Episcleritis is mainly idiopathic but may be secondary to an underlying rheumatologic disease. Despite being rare, drug-associated episcleritis and scleritis should also be included in the differential diagnosis. Tumor necrosis factor-alpha (TNF-α) inhibitors are generally well-tolerated, but etanercept, in particular, has the potential to cause paradoxical adverse reactions including ocular inflammations, such as uveitis, scleritis, and ocular myositis. Etanercept differs in its mechanism of action from other TNF-α inhibitors as it acts as a decoy receptor, and this may partly explain the more frequently reported etanercept-associated ocular inflammation. Etanercept may also be ineffective in preventing ocular inflammation. However, the dechallenge and rechallenge phenomena have proven there is a causative link between etanercept and new-onset ocular inflammation. We report a case of a 15-year-old boy with enthesitis-related arthritis and familial Mediterranean fever who presented with episcleritis and blepharitis while receiving etanercept treatment and subsequently showed dechallenge and rechallenge reactions. Therefore, physicians should also be aware that episcleritis should be considered a paradoxical adverse reaction to etanercept and can occur in pediatric patients. We also reviewed the English literature to provide an overview and evaluate intervention options.
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  • 文章类型: Case Reports
    双膦酸盐是广泛用于治疗骨质疏松症的药物。在口服双膦酸盐不耐受或不依从性的情况下,经常使用静脉(IV)唑来膦酸(ZA)。众所周知的立即ZA副作用包括流感样症状,如恶心,肌痛,骨骼和关节疼痛,和发烧。在这里,我们报告了一例罕见的急性前葡萄膜炎副作用的病例,该病例最初服用ZA后,患有骨质疏松症的71岁女性在几个月前缺乏维生素D。她出现了头痛,双侧眼睛发红,和ZA输注后疼痛。弥漫性结膜注射的发现,前房细胞耀斑提示前葡萄膜炎。用泼尼松龙滴眼液在三周内缓解了她的症状。眼部炎症是这种常用药物的罕见但严重的副作用。在治疗前优化维生素D水平可能有助于预防这种情况。临床医生应该意识到ZA后眼部炎症的罕见发生。早期识别和及时治疗至关重要。
    Bisphosphonates are widely used drugs for the management of osteoporosis. Intravenous (IV) zoledronic acid (ZA) is frequently prescribed in cases of oral bisphosphonate intolerance or non-compliance. Well-known immediate ZA side effects include flu-like symptoms such as nausea, myalgias, bone and joint pains, and fever. Here we report a case of a rare side effect of acute anterior uveitis following initial dosing of ZA in a 71-year-old female with osteoporosis who had been vitamin D deficient a couple of months earlier. She presented with headache, bilateral eye redness, and pain post ZA infusion. Findings of diffuse conjunctival injection, and flare with cells in the anterior chamber were suggestive of anterior uveitis. Her symptoms resolved with prednisolone eye drops in three weeks. Ocular inflammation is a rare but serious side effect of this commonly administered drug. Optimizing vitamin D levels prior to treatment may help to prevent this condition. Clinicians should be aware of the rare occurrence of post-ZA ocular inflammation. Early recognition and prompt treatment are essential.
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  • 文章类型: Case Reports
    脉络膜上曲安奈德(SCS-TA)注射最近被批准用于治疗继发于非感染性葡萄膜炎的黄斑水肿。然而,其在治疗后巩膜炎方面的应用尚未见报道。我们报告了第一例用于治疗后巩膜炎的SCS-TA。一名67岁女性后巩膜炎并发渗出性视网膜脱离,通过谱域光学相干断层扫描(OCT)诊断,带着痛苦,视力下降,左眼发红8个月。以前给她开了局部泼尼松龙和口服泼尼松,但改善很小。她也有用多种全身免疫抑制剂治疗的类风湿性关节炎病史。在SCS-TA之后,患者疼痛缓解,视力改善。OCT显示硬化脉络膜增厚显著减少。通过其新颖的递送方法,SCS-TA可能是后巩膜炎的有效治疗方法。需要进一步的研究来确定这种治疗方式的长期疗效和安全性。
    Suprachoroidal triamcinolone acetonide (SCS-TA) injections were recently approved to treat macular edema secondary to noninfectious uveitis. However, its use in managing posterior scleritis has not been reported. We report the first case of SCS-TA used in the treatment of posterior scleritis. A 67-year-old woman with posterior scleritis complicated by exudative retinal detachment, diagnosed by spectral-domain optical coherence tomography scan (OCT), presented with pain, decreased vision, and redness in the left eye for 8 months. She was previously prescribed topical prednisolone and oral prednisone with minimal improvement. She also had a history of rheumatoid arthritis treated with multiple systemic immunosuppressive agents. After SCS-TA, the patient\'s pain resolved and visual acuity improved. OCT demonstrated significant reduction in sclerochoroidal thickening. Via its novel delivery method, SCS-TA may be an effective treatment for posterior scleritis. Further studies are needed to establish long-term efficacy and safety of this treatment modality.
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  • 文章类型: Journal Article
    据报道,成人人群接种COVID-19疫苗后发生眼部炎症事件。
    18岁以下的跨国病例系列患者在COVID-19疫苗接种后28天内被诊断为眼部炎症事件。
    包括20个人。最常见的事件是前葡萄膜炎(n=8,40.0%),其次是中度葡萄膜炎(7例,35%),全葡萄膜炎(4例,20%),和后葡萄膜炎(1名患者,5%)。在接种疫苗后的第一周,有11名患者(55.0%)发现了该事件。12例患者(60.0%)曾有过眼内炎症事件的病史。患者接受局部皮质类固醇治疗(n=19,95.0%),口服皮质类固醇(n=10,50.0%),或增加免疫抑制治疗剂量(n=6,30.0%)。13例患者(65.0%)的眼部事件完全缓解,无并发症。所有患者的最终视力未受影响或损失少于三条线。
    接种COVID-19疫苗后,儿科人群可能会发生眼部炎症事件。大多数事件都得到了成功治疗,都表现出良好的视觉效果。
    UNASSIGNED: Ocular inflammatory events following COVID-19 vaccination have been reported in the adult population.
    UNASSIGNED: Multinational case series of patients under the age of 18 diagnosed with ocular inflammatory events within 28 days of COVID-19 vaccination.
    UNASSIGNED: Twenty individuals were included. The most common event was anterior uveitis (n = 8, 40.0%), followed by intermediate uveitis (7 patients, 35%), panuveitis (4 patients, 20%), and posterior uveitis (1 patient, 5%). The event was noticed in the first week after vaccination in 11 patients (55.0%). Twelve patients (60.0%) had a previous history of intraocular inflammatory event. Patients were managed with topical corticosteroids (n = 19, 95.0%), oral corticosteroids (n = 10, 50.0%), or increased dose of immunosuppressive treatment (n = 6, 30.0%). Thirteen patients (65.0%) had a complete resolution of the ocular event without complications. All patients had a final visual acuity unaffected or less than three lines of loss.
    UNASSIGNED: Ocular inflammatory events may happen in the paediatric population following COVID-19 vaccination. Most events were successfully treated, and all showed a good visual outcome.
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  • 文章类型: Journal Article
    目的:报道给予抗SARS-CoV-2的BNT162b2mRNA疫苗后眼部后不良事件的发生。
    方法:回顾性连续病例系列,其中疫苗接种后30天内出现眼部不良事件的患者的医疗档案,进行了分析。
    结果:本研究包括4名患者(2名女性)。诊断包括:后巩膜炎,急性中央中度黄斑病变,疱疹全葡萄膜炎,和Vogt-Koyanagi-Harada(VKH)类似葡萄膜炎。其中三名患者没有相关的眼部病史,但是患上巩膜炎的患者在没有药物治疗的情况下已经缓解了四年,直到爆发,这发生在疫苗接种后的一天。所有患者经治疗好转。
    结论:虽然因果关系无法确定,时间关系提示COVID-19疫苗与眼部后部并发症之间可能存在关联.接种疫苗的好处显然大于潜在的不利影响;然而,眼科医生应该意识到疫苗相关葡萄膜炎的可能性.
    OBJECTIVE: To report the occurrence of posterior ocular adverse events following the administration of the BNT162b2 mRNA vaccine against SARS-CoV-2.
    METHODS: A retrospective consecutive case series, in which the medical files of patients presenting with ocular adverse events within 30 days of the vaccine inoculation, were analyzed.
    RESULTS: Four patients (2 females) were included in the study. The diagnoses included: posterior scleritis, paracentral acute middle maculopathy, herpes panuveitis, and Vogt-Koyanagi-Harada (VKH)-like uveitis. Three of the patients had no relevant ocular history, but the patient who developed scleritis was in remission without medical therapy for four years, until the flare-up, which occurred one day after the vaccine. All patients improved with treatment.
    CONCLUSIONS: Though a causal relationship cannot be definitively established, the temporal relationship suggests a possible link between the COVID-19 vaccine and the posterior ocular complications. The benefits of vaccination clearly outweigh the potential adverse effects; however, ophthalmologists should be aware of the potential for vaccine-associated uveitis.
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  • 文章类型: Journal Article
    背景:在对疫苗的免疫原性和安全性日益担忧的情况下,据报道,COVID-19疫苗接种后的炎症不良事件,尤其是预先存在炎症的患者。
    方法:2021年在3个月期间,从40个中心收集了在COVID-19疫苗接种后14天内被诊断为眼部炎症事件的多国病例系列患者。
    结果:70例患者在接种COVID-19疫苗后14天内出现眼部炎症事件。平均年龄为51岁(范围,19-84岁)。最常见的事件是前葡萄膜炎(n=41,58.6%),其次是后葡萄膜炎(n=9,12.9%)和巩膜炎(n=7,10.0%)。事件发生的平均时间为5天和6天(范围,1-14天)在第一剂和第二剂疫苗后,分别。在所有患者中,36人(54.1%)曾有眼部炎症事件的病史。大多数患者(n=48,68.6%)接受了局部皮质类固醇治疗。65例(92.9%)最终视力未受影响,而2(2.9%)和3(4.3%)视力下降≤3行和>3行,分别。报告的并发症包括角膜角膜角膜损伤(n=1,1.4%),黄斑囊样水肿(n=2,2.9%)和黄斑瘢痕(n=2,2.9%)。
    结论:COVID-19疫苗接种后可能发生眼部炎症事件。这些发现是基于不能证明因果关系的时间关联。即使在因果关系的可能性中,大多数事件是轻度的,并且具有良好的视觉结局.
    BACKGROUND: Inflammatory adverse events following COVID-19 vaccination are being reported amidst the growing concerns regarding vaccine\'s immunogenicity and safety, especially in patients with pre-existing inflammatory conditions.
    METHODS: Multinational case series of patients diagnosed with an ocular inflammatory event within 14 days following COVID-19 vaccination collected from 40 centres over a 3 month period in 2021.
    RESULTS: Seventy patients presented with ocular inflammatory events within 14 days following COVID-19 vaccination. The mean age was 51 years (range, 19-84 years). The most common events were anterior uveitis (n = 41, 58.6%), followed by posterior uveitis (n = 9, 12.9%) and scleritis (n = 7, 10.0%). The mean time to event was 5 days and 6 days (range, 1-14 days) after the first and second dose of vaccine, respectively. Among all patients, 36 (54.1%) had a previous history of ocular inflammatory event. Most patients (n = 48, 68.6%) were managed with topical corticosteroids. Final vision was not affected in 65 (92.9%), whereas 2 (2.9%) and 3 (4.3%) had reduction in visual acuity reduced by ≤3 lines and > 3 lines, respectively. Reported complications included nummular corneal lesions (n = 1, 1.4%), cystoid macular oedema (n = 2, 2.9%) and macular scarring (n = 2, 2.9%).
    CONCLUSIONS: Ocular inflammatory events may occur after COVID-19 vaccination. The findings are based on a temporal association that does not prove causality. Even in the possibility of a causal association, most of the events were mild and had a good visual outcome.
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  • 文章类型: Review
    视网膜膜(ERM)是葡萄膜炎的常见并发症,可能独立地导致葡萄膜炎患者的视力丧失。尽管先前已经报道了自发性特发性ERM分离,据我们所知,科学文献中只有两份病例报告描述了炎症相关ERM的自发消退.自发性ERM分离是一种罕见但可能的事件,最常发生在玻璃体后脱离之后。我们介绍了三个葡萄膜炎患者的病例系列,这些患者表现出炎症性ERM的形成和随后的自发消退。
    Epiretinal membrane (ERM) represents a common complication of uveitis that may contribute independently to vision loss in patients with uveitis. Although spontaneous idiopathic ERM separation has been previously reported, to the best of our knowledge there are only two case reports in the scientific literature that depicts spontaneous regression of an inflammation-associated ERM. Spontaneous ERM separation is a rare but possible event, which occurs most often subsequent to posterior vitreous detachment. We present a case series of three patients with uveitis that exhibit the formation and subsequent spontaneous resolution of an inflammatory ERM.
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