Purpose:To describe the clinical features of post-streptoc-occal uveitis(PSU)and examine management strategies in the treatment of this under-recognized condition.Methods:Patients were identified from the world litera...Purpose:To describe the clinical features of post-streptoc-occal uveitis(PSU)and examine management strategies in the treatment of this under-recognized condition.Methods:Patients were identified from the world literature using the Pubmed search engine.We examined two new cases of post-streptococcal intermediate uveitis.The epidemiology,immune mechanisms,clinical features,investigations,treatments and visual outcomes were examined and recorded.Results:We reviewed 11 patients including our own two cases.There was a statistically significant seasonal difference in antistreptolysin-O titres(ASOT),and age-related ASOT was identified.Of the 11 patients,eight(72.7%)had anterior uveitis,two(18.2%)had intermediate uveitis and one(9.1%)had panuveitis.Their ages ranged from 5 to 56 years(mean 17 years).The majority of cases had significantly elevated ASOT;most patients were treated with topical steroids and oral antibiotics and four cases underwent adenotonsillectomy.The visual prognosis was good in most cases.Conclusions:Uveitis may be the sole presenting clinical feature,or it may occur in combination with other features of post-streptococcal infection.Ophthalmologists should be aware of the clinical features of PSU and maintain a high level of suspicion,particularly in childhood uveitis.展开更多
患儿女,7岁。因双眼红、畏光、伴视力下降1周,于2019年6月29日到复旦大学附属眼耳鼻喉科医院就诊。患儿生长发育正常。无家族遗传病史。5周前有流感样症状伴发热、咽痛,当地医院儿科就诊查体:体温37.7℃,咽部充血,扁桃体肿大,颜面部皮...患儿女,7岁。因双眼红、畏光、伴视力下降1周,于2019年6月29日到复旦大学附属眼耳鼻喉科医院就诊。患儿生长发育正常。无家族遗传病史。5周前有流感样症状伴发热、咽痛,当地医院儿科就诊查体:体温37.7℃,咽部充血,扁桃体肿大,颜面部皮肤潮红伴躯干部散在“粟粒样”皮疹。当地医院诊断为“猩红热(链球菌感染)”,给予口服阿莫西林治疗后全身症状好转。眼科检查:右眼、左眼最佳矫正视力(BCVA)分别为0.2、0.1。右眼、左眼眼压分别为13、14 mm Hg(1 mm Hg=0.133 kPa)。双眼轻度混合充血,尘状角膜后沉着物,前房、玻璃体少量细胞。眼底检查,双眼视网膜静脉稍纡曲,视网膜血管霜样渗出(图1A,1B)。光相干断层扫描(OCT)检查,双眼黄斑囊样水肿伴黄斑中心凹视网膜脱离(图1C,1D)。荧光素眼底血管造影检查,造影晚期双眼视盘及视网膜静脉荧光素渗漏明显,周边未见明显无灌注区(图1E,1F)。眼部B型超声检查,双眼玻璃体全段中量细点状回声,伴后极部视网膜水肿(图1G,1H)。展开更多
文摘Purpose:To describe the clinical features of post-streptoc-occal uveitis(PSU)and examine management strategies in the treatment of this under-recognized condition.Methods:Patients were identified from the world literature using the Pubmed search engine.We examined two new cases of post-streptococcal intermediate uveitis.The epidemiology,immune mechanisms,clinical features,investigations,treatments and visual outcomes were examined and recorded.Results:We reviewed 11 patients including our own two cases.There was a statistically significant seasonal difference in antistreptolysin-O titres(ASOT),and age-related ASOT was identified.Of the 11 patients,eight(72.7%)had anterior uveitis,two(18.2%)had intermediate uveitis and one(9.1%)had panuveitis.Their ages ranged from 5 to 56 years(mean 17 years).The majority of cases had significantly elevated ASOT;most patients were treated with topical steroids and oral antibiotics and four cases underwent adenotonsillectomy.The visual prognosis was good in most cases.Conclusions:Uveitis may be the sole presenting clinical feature,or it may occur in combination with other features of post-streptococcal infection.Ophthalmologists should be aware of the clinical features of PSU and maintain a high level of suspicion,particularly in childhood uveitis.
文摘患儿女,7岁。因双眼红、畏光、伴视力下降1周,于2019年6月29日到复旦大学附属眼耳鼻喉科医院就诊。患儿生长发育正常。无家族遗传病史。5周前有流感样症状伴发热、咽痛,当地医院儿科就诊查体:体温37.7℃,咽部充血,扁桃体肿大,颜面部皮肤潮红伴躯干部散在“粟粒样”皮疹。当地医院诊断为“猩红热(链球菌感染)”,给予口服阿莫西林治疗后全身症状好转。眼科检查:右眼、左眼最佳矫正视力(BCVA)分别为0.2、0.1。右眼、左眼眼压分别为13、14 mm Hg(1 mm Hg=0.133 kPa)。双眼轻度混合充血,尘状角膜后沉着物,前房、玻璃体少量细胞。眼底检查,双眼视网膜静脉稍纡曲,视网膜血管霜样渗出(图1A,1B)。光相干断层扫描(OCT)检查,双眼黄斑囊样水肿伴黄斑中心凹视网膜脱离(图1C,1D)。荧光素眼底血管造影检查,造影晚期双眼视盘及视网膜静脉荧光素渗漏明显,周边未见明显无灌注区(图1E,1F)。眼部B型超声检查,双眼玻璃体全段中量细点状回声,伴后极部视网膜水肿(图1G,1H)。