患者男性,45岁。因6 d前被雨水冲刷后发现左眼红、痛、畏光、流泪,伴黄色分泌物增加,视力下降,曾就诊于当地诊所,给予抗炎后症状未见缓解,后就诊于县人民医院经抗炎及支持治疗后症状进一步加剧,遂来我院进一步诊治。患者全身情况重未见...患者男性,45岁。因6 d前被雨水冲刷后发现左眼红、痛、畏光、流泪,伴黄色分泌物增加,视力下降,曾就诊于当地诊所,给予抗炎后症状未见缓解,后就诊于县人民医院经抗炎及支持治疗后症状进一步加剧,遂来我院进一步诊治。患者全身情况重未见明显异常。既往史无特殊。专科检查：视力：右眼：0.8,左眼：手动/眼前;眼压：右眼14 mm Hg,左眼Tn。右眼检查未见明显异常。展开更多
Background: To report a case of lymphomatous infiltration and bilateral retinal vasculitis observed among 83 cases of adult Tcell leukemia (ATL) treated in the University Hospital Center in Fort-de-France (Martinique,...Background: To report a case of lymphomatous infiltration and bilateral retinal vasculitis observed among 83 cases of adult Tcell leukemia (ATL) treated in the University Hospital Center in Fort-de-France (Martinique, French West Indies) between 1984 and 2003. Case: A complete clinical ophthalmologic examination was performed in this patient along with fluorescein angiography. Observations: After being checked for diffuse adenopathies, myodesopsias, and phosphenes, the 35-yearold patient was diagnosed with ATL. The ocular impairment, present since the onset of ATL as peripheral subretinal infiltrates, spread progressively and afferently to the rest of the retina in the form of an essentially venous vasculitis. Impairment of the vitreous was noted only in the end stages of disease progression. As ocular lesions progressed, the general state of the patient degraded at the same time despite chemotherapeutic measures. Conclusion: Among the more than 300 seropositive for human T-cell lymphotropic virus type 1 (HTLV-1) or patients with HTLV-1- associated myelopathy/tropical spastic paraparesis treated at our hospital in the last 20 years, and among the 83 cases of ATL, only this single case of retinal vasculitis associated with HTLV-1 was observed (1/83, 1.2% ) in Martinique, confirming the geographic variability of the clinical phenotype of HTLV-1 infection. The incidence of retinal vasculitis in ATL patients may signify an even worse prognosis than initially indicated.展开更多
文摘患者男性,45岁。因6 d前被雨水冲刷后发现左眼红、痛、畏光、流泪,伴黄色分泌物增加,视力下降,曾就诊于当地诊所,给予抗炎后症状未见缓解,后就诊于县人民医院经抗炎及支持治疗后症状进一步加剧,遂来我院进一步诊治。患者全身情况重未见明显异常。既往史无特殊。专科检查：视力：右眼：0.8,左眼：手动/眼前;眼压：右眼14 mm Hg,左眼Tn。右眼检查未见明显异常。
文摘Background: To report a case of lymphomatous infiltration and bilateral retinal vasculitis observed among 83 cases of adult Tcell leukemia (ATL) treated in the University Hospital Center in Fort-de-France (Martinique, French West Indies) between 1984 and 2003. Case: A complete clinical ophthalmologic examination was performed in this patient along with fluorescein angiography. Observations: After being checked for diffuse adenopathies, myodesopsias, and phosphenes, the 35-yearold patient was diagnosed with ATL. The ocular impairment, present since the onset of ATL as peripheral subretinal infiltrates, spread progressively and afferently to the rest of the retina in the form of an essentially venous vasculitis. Impairment of the vitreous was noted only in the end stages of disease progression. As ocular lesions progressed, the general state of the patient degraded at the same time despite chemotherapeutic measures. Conclusion: Among the more than 300 seropositive for human T-cell lymphotropic virus type 1 (HTLV-1) or patients with HTLV-1- associated myelopathy/tropical spastic paraparesis treated at our hospital in the last 20 years, and among the 83 cases of ATL, only this single case of retinal vasculitis associated with HTLV-1 was observed (1/83, 1.2% ) in Martinique, confirming the geographic variability of the clinical phenotype of HTLV-1 infection. The incidence of retinal vasculitis in ATL patients may signify an even worse prognosis than initially indicated.
