玻璃体注射曲安奈德后出现eb病毒性葡萄膜炎

Q4 Medicine

Asian Journal of Ophthalmology Pub Date : 2021-04-16 DOI:10.35119/ASJOO.V17I4.616

J. Ong, J. Richards

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引用次数: 0

摘要

目的:报告1例玻璃体注射曲安奈德后发生eb病毒(EBV)葡萄膜炎。方法:观察性病例报告。结果:66岁男性，急性感染性单核细胞增多症后3个月出现双侧中间葡萄膜炎，左侧黄斑分支视网膜静脉闭塞，左侧黄斑水肿。他接受了全身强的松龙、甲氨蝶呤和玻璃体内贝伐单抗治疗，部分缓解。玻璃体内注射曲安奈德治疗复发性黄斑水肿，导致房水中EBV PCR阳性的严重全葡萄膜炎。用大剂量全身伐昔洛韦和局部强的松龙成功治疗。结论:非感染性葡萄膜炎可能在玻璃体内注射类固醇引起眼内病毒复制后变为感染性。在怀疑感染的病例中应检测眼内液，EBV应被视为鉴别诊断，特别是如果PCR对更常见的病毒病因呈阴性。

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Epstein-Barr virus uveitis after intravitreal triamcinolone injection

Purpose: To report a case of Epstein-Barr virus (EBV) uveitis after intravitreal triamcinolone injection. Methods: Observational case report. Results: A 66-year-old male presented with bilateral intermediate uveitis, left macular branch retinal vein occlusion, and left macular edema 3 months following acute infectious mononucleosis. He received systemic prednisolone, methotrexate, and intravitreal bevacizumab with partial response. Intravitreal triamcinolone was given for recurrent macular edema, which led to the development of severe panuveitis with positive EBV PCR in aqueous humour. This was successfully treated with high-dose systemic valaciclovir and topical prednisolone. Conclusion: Non-infectious uveitis may become infectious following intravitreal steroid administration triggering intraocular viral replication. Intraocular fluid should be tested in cases which are suspicious for infection and EBV should be considered a differential diagnosis, particularly if PCR is negative for more common viral etiologies.

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来源期刊

Asian Journal of Ophthalmology Medicine-Ophthalmology

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期刊介绍： Asian Journal of OPHTHALMOLOGY is the official peer-reviewed journal of the South East Asia Glaucoma Interest Group (SEAGIG) and is indexed in EMBASE/Excerpta Medica. Asian Journal of OPHTHALMOLOGY is published quarterly (four [4] issues per year) by Scientific Communications International Limited. The journal is published on-line only and is distributed free of cost via the SEAGIG website.