一种罕见的毁灭性疾病——眼内眼病1例

S. Noman, Murtuza Nuruddin
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摘要

摘要报告一例罕见的单侧内眼病伴完全视力丧失的病例。方法:一名健康的12岁男孩,在过去的12天里,他的右眼出现了红肿和痛苦的快速视力丧失。没有相关的创伤史。经检查,右眼无光感,左眼视力正常。严重的前、后段炎症妨碍了眼底的观察。右眼b超显示弥漫性脉络膜及视神经增厚。常规血球计数和胸部x光检查未发现任何重大发现。在诊断不确定的情况下,为了减轻患者的剧烈疼痛,我们对右眼进行了剜出,并对标本进行了组织病理学检查以确认诊断。结果:组织病理学报告显示脉络膜明显不规则炎性增厚伴严重肉芽肿性炎症。脉络膜内有感染因子,有外角质层和不规则的透明分枝内管。这些特征提示脉络膜眼肿病。结论:眼肿病虽少见,但在鉴别诊断全葡萄膜炎时应予以重视。当怀疑有肿瘤或其他疾病时,及早发现这种情况,可以避免侵入性的手术,如去核。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Case History of Internal Ophthalmomyiasis, a Rare and Devastating Disease
To report a rare case of unilateral internal ophthalmomyiasis with complete visual loss. Method: An otherwise healthy 12 years old boy presented with redness and painful rapid loss of vision in his right eye for the past 12 days. There was no history of associated trauma. On examination, there was no perception of light in his right eye and normal vision in left eye. There was severe anterior and posterior segment inflammation which prevented the view of fundus. B-scan of the right eye showed diffuse choroidal and optic nerve thickening. Routine blood count and X-ray chest did not reveal any significant findings. In the midst of uncertainity regarding diagnosis and to relieve the patient from severe pain, enucleation of right eye was performed and histopathological examination of the specimen was done to confirm the diagnosis. Result: Histopathology report showed gross irregular inflammatory thickening of the choroid with severe granulomatous inflammation. There was an infective agent in the choroid having an outer cuticle and an irregular hyaline branching innner tube. These features were suggestive of ophthalmomyiasis of the choroid. Conclusion: Although rare, ophthalmomyiasis should be considered in the differential diagnosis of panuveitis. Early recognition of this condition, when tumour and other conditions are suspected, would avoid invasive surgical procedures, such as enucleation.
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