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首页> 外文期刊>British Journal of Medicine and Medical Research >Idiopathic Necrotizing Scleritis, Anterior Uveitis, and Localized Retinal Detachment
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Idiopathic Necrotizing Scleritis, Anterior Uveitis, and Localized Retinal Detachment

机译：特发性坏死性巩膜炎，前葡萄膜炎和局限性视网膜脱离

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Aim: To present clinical picture and treatment of anterior idiopathic necrotizing scleritis. Methods: Clinical and laboratory examination; B-scan ultrasound; tissue biopsy and histological analysis, were performed. Results: Herewith we depict a case of 74 year old man, with unilateral granulomatous, anterior, necrotizing scleritis. Etiology has, through extensive testing, both laboratorial and clinical, not been proven and thus the patient has been classified as having idiopathic scleritis. Complications on both anterior (anterior uveitis) and posterior (subretinal granulomatous infiltrates with localized retinal detachment) segments of the eye are a consequence of granulomatous necrotizing scleritis. Both tissue biopsy of granulomatous scleral infiltrates and histological analysis showed that this is the case of granulomatous, partially necrotizing scleritis with some elements of vasculitis. Progression of granulomatous scleral infiltrates into the eye has also been shown through clinical examination and B-scan ultrasound, and depicted subretinal lesion of medium reflectivity that is in contact with the epibulbar lesion. Retinal detachment in this area had progressed and required excessive laser photocoagulation barrage and resulted in absorption of subretinal fluid. Positive therapeutic outcome was achieved through the use Methotrexate and corticosteroids. Conclusion: Granulomatous infiltrates that spread towards the subretinal space and result in localized retinal detachment are a rare complication that may occur during the evolution of necrotizing scleritis and require regular monitoring and followup. Treatment, both pharmaceutical and laser photocoagulation, should be adjusted in order to affect progression and prevent possible complications of the disease.
机译：目的：介绍前发性特发性坏死性巩膜炎的临床图片和治疗方法。方法：临床和实验室检查; B超检查进行组织活检和组织学分析。结果：我们在此描述了一名74岁的男性，患有单侧肉芽肿，前部，坏死性巩膜炎。病因学已经通过实验室和临床的广泛测试尚未得到证实，因此该患者已被分类为患有特发性巩膜炎。眼前段（前葡萄膜炎）和后段（视网膜下肉芽肿浸润伴视网膜局部脱离）的并发症是肉芽肿坏死性巩膜炎的结果。肉芽肿性巩膜浸润的组织活检和组织学分析均显示为肉芽肿性，部分坏死性巩膜炎伴某些血管炎的情况。还通过临床检查和B超检查显示肉芽肿性巩膜浸润进入眼内的进展，并描绘了与上reflect骨病变相接触的中等反射率的视​​网膜下病变。该区域的视网膜脱离已经进展，需要过多的激光光凝屏障，导致视网膜下液的吸收。通过使用甲氨蝶呤和皮质类固醇获得积极的治疗效果。结论：肉芽肿浸润扩散到视网膜下间隙并导致局部视网膜脱离是罕见的并发症，可能在坏死性巩膜炎演变过程中发生，需要定期监测和随访。应该调整药物和激光光凝治疗，以影响疾病进展并预防疾病的可能并发症。

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