■要报告异常关联,非典型临床表现,以及定制治疗病毒性葡萄膜炎和青光眼的结果。
■诊断为病毒性葡萄膜炎合并青光眼的患者,在2013年至2020年期间在三级眼部护理中心进行了筛查。24例病毒性葡萄膜炎的未分类或非典型临床表现的患者,非典型临床病程,或诊断挑战和相关的青光眼,包括在内。具有病毒性前葡萄膜炎或后葡萄膜炎的典型特征的患者,其他形式的自身免疫性/感染性/创伤性葡萄膜炎,被排除在外。
■对系统性抗病毒治疗有反应的青光眼滤过手术后,病毒再激活导致脉络膜反复发作,大量颜料粉尘/羽流作为呈现特征,与虹膜新内皮(ICE)综合征相似的多发性进行性局灶性前粘连,在青光眼中不寻常的病毒性葡萄膜炎队列中观察到。高度怀疑指数有助于在安然无恙的Ahmed青光眼瓣膜手术(AGV)或YAG囊切开术后激光术后高眼压(IOP)病例中诊断病毒病因,推测的Posner-Schlossman综合征伴多次复发或推测的类固醇性青光眼。所有患者使用抗病毒和定制的伴随类固醇反应良好,在一只发生视神经萎缩的眼睛中观察到视力丧失的抗青光眼治疗。
■应牢记青光眼病毒性葡萄膜炎的罕见临床表现或关联。高度怀疑和量身定制的及时治疗可以确保良好的结果,从而防止青光眼进一步的视觉发病率。
UNASSIGNED: To report unusual associations, atypical clinical presentations, and outcomes of tailored treatment of viral uveitis and glaucoma.
UNASSIGNED: Patients diagnosed with viral uveitis with associated glaucoma, seen at a tertiary eye care center between 2013 and 2020, were screened. Twenty-four patients with unclassified or atypical clinical presentations of viral uveitis, atypical clinical course, or with diagnostic challenges and associated glaucoma, were included. Patients with classical features of viral anterior or posterior uveitis, other forms of autoimmune/infectious/traumatic uveitis, were excluded.
UNASSIGNED: Viral re-activation causing recurrent choroidals after glaucoma filtering surgery responsive to systemic antiviral therapy, massive pigment dusting/plume as a presenting feature, multiple progressive focal anterior synechiae similar to iridocorneoendothelial (ICE) syndrome, were seen in this cohort of unusual viral uveitis in glaucoma. A high index of suspicion helped diagnose a viral etiology in cases with high intraocular pressure (IOP) after uneventful Ahmed glaucoma valve surgery (AGV) or post-YAG capsulotomy laser, presumed Posner-Schlossman syndrome with multiple recurrences or presumed steroid glaucoma. All patients responded well with anti-viral and tailored concomitant steroids, anti-glaucoma therapy with loss of visual acuity seen in one eye developing optic atrophy.
UNASSIGNED: Uncommon clinical presentations or associations of viral uveitis in glaucoma should be kept in mind. A high index of suspicion and tailored prompt treatment may ensure good outcomes preventing further visual morbidity in glaucoma.