镜像化动脉的困境
Skenda Jean-Charles1, Marissa K Shoji1, Don O Kikkawa1
1Viterbi Department of Ophthalmology, University of California San Diego San Diego, CA, USA.
Survey of ophthalmology
|March 2, 2025
概括
巨细胞动脉炎 (GCA) 可以导致视力丧失. 双边动脉活检对于准确的诊断至关重要,即使一侧是阴性,也有助于GCA管理.
科学领域:
- 眼科医生 眼科 眼科
- 类风湿病学 类风湿病学
- 病理学 病理学 病理学
背景情况:
- 巨细胞动脉炎 (GCA) 是老年人可预防的视力丧失的主要原因.
- 急性无痛视力丧失需要立即对GCA进行评估.
研究的目的:
- 评估双边动脉活检 (TAB) 在疑似出现视力丧失的GCA病例的诊断效用.
- 讨论GCA的诊断挑战和管理策略.
主要方法:
- 一个89岁的男性患有急性视力丧失的案例介绍.
- 临床评估,包括神经学工作和炎症标志物.
- 在启动皮质类固醇治疗后进行双边动脉活检 (TAB).
主要成果:
- 左眼的视力是光线感知与光盘胀.
- 左TAB的组织病理学为动脉炎呈阴性.
- 反侧 (右) TAB 的组织病理学结果为动脉炎阳性.
结论:
- 单边负TAB并不排除GCA,特别是在视力丧失的背景下.
- 双边TAB对于确定GCA诊断至关重要,优化治疗并防止进一步的并发症.
- 早期的皮质类固醇治疗至关重要,但活检结果指导了长期管理.
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