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Panuveitis hiperaguda estacional desde la altitud más alta reportada: ocurrencia concomitante con escleritis - una
Ranju Kharel Sitaula1,2, Pratap Karki3, Prabin Poudel4
1Department of Ophthalmology, Maharajgunj Medical Campus, Institute of Medicine, B.P. Koirala Lions Centre for Ophthalmic Studies, Tribhuvan University, Kathmandu, Nepal. ranju.kharelsitaula@studenti.unipd.it.
BMC ophthalmology
|August 25, 2025
Resumen
Este estudio informa de un caso raro de Panuveitis Hiperaguda Estacional (SHAPU) en una región de gran altitud de Nepal, complicado por esclerosis necrotising. El caso pone de relieve nuevos aspectos potenciales de la fisiopatología de SHAPU, incluido el dolor ocular intenso en altitudes más altas.
Área de la Ciencia:
- Oftalmología
- Entomología
- Etiología de las enfermedades oculares
Sus antecedentes:
- La panuveítis hiperaguda estacional (SHAPU) es una panuveítis grave y de rápido progreso.
- A menudo se asocia con polillas del género Gazalina, particularmente sus setas o masas de huevos.
- SHAPU afecta principalmente a los niños y está típicamente relacionado con altitudes más bajas.
Objetivo del estudio:
- Informar de un caso raro de SHAPU que ocurre a gran altitud (clima alpino) en Nepal.
- Para documentar la presencia simultánea de escleritis necrotizante en este caso de SHAPU.
- Investigar las posibles diferencias en la presentación de SHAPU a elevaciones más altas.
Principales métodos:
- Un informe de caso de un hombre de 27 años de edad, caminante del este de Nepal.
- El paciente presentó una aparición repentina de dolor ocular severo, enrojecimiento y disminución de la visión después del contacto indirecto con una polilla hembra de Gazalina.
- El examen clínico reveló inflamación de la cámara anterior y escleritis necrotizante; la ecografía ocular confirmó la vitritis.
Principales resultados:
- El paciente desarrolló SHAPU con escleritis necrotizante a una altitud de 4.371 m.
- El tratamiento agresivo con antibióticos y esteroides evitó la perforación escleral.
- A pesar del tratamiento, no se logró la rehabilitación visual.
Conclusiones:
- SHAPU puede afectar el tejido escleral, no sólo la úvea.
- Este caso de gran altitud con dolor intenso sugiere nuevos aspectos fisiopatológicos de SHAPU.
- Se requiere más investigación sobre el hábitat de la polilla a mayores altitudes para comprender los factores ambientales que desencadenan SHAPU.
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