目的对比分析急性期Vogt-Koyanagi-Harada综合征(VKH)和急性期中心性浆液性脉络膜视网膜病变(CSC)患眼视盘参数及环视盘RNFL厚度的差异。方法回顾性临床病例对照分析。2014年1月至2018年2月在广东医科大学附属医院眼科确诊为急性期VKH的20例患者38只眼(VKH组)以及急性期CSC 37例患者37只眼(CSC组)纳入研究。两组患者年龄(t=0.45,P=0.65)比较,差异无统计学意义。纳入同期年龄、性别、眼别均与VKH组、CSC组相匹配的健康体检者57例75只眼作为正常对照组。所有受检眼均进行视盘3D-OCT检查。视盘面积、视杯面积、盘沿面积、C/D面积比、C/D水平直径比、C/D垂直直径比、环视盘(CP)-RNFL平均厚度及鼻侧、上方、颞侧、下方各象限的CP-RNFL厚度由系统自带软件自动测量计算所得。应用PicPick软件对OCT断层图像进行后处理,测量视盘两端RPE终末端延长线的夹角(简称视盘RPE夹角)。对比分析3组受检眼视盘RPE夹角以及VKH组、CSC组患眼的视盘参数和CP-RNFL厚度。3组间视盘RPE夹角比较采用方差分析,两两比较采用最小显著差法 t 检验。结果 VKH组中29只眼(76.32%)出现视盘旁视网膜脱离(RD),21只眼(55.26%)出现视盘充血;CSC组12只眼(32.43%)出现视盘旁RD,未发现视盘充血。两组出现视盘旁RD的眼数比较,差异有统计学意义(χ2=14.57,P<0.01)。VKH组、CSC组、正常对照组受检眼视盘RPE夹角分别为(138.62±11.96)°、(154.09±5.85)°、(153.41±5.77)°。VKH组患眼视盘RPE夹角较CSC组(t=-2.05,P=0.00)、正常对照组(t=-1.68,P=0.00)变小,差异有统计学意义。CSC组患眼视盘RPE夹角与正常对照组比较,差异无统计学意义(t=-1.88,P=0.72)。VKH组患眼视盘面积、盘沿面积较CSC组变大,差异有统计学意义(t=4.61、2.71,P=0.00、0.01);两组患眼其余视盘各参数比较,差异无统计学意义(P>0.05)。VKH组患眼CP-RNFL厚度以及鼻侧、上方、颞侧、下方各象限CP-RNFL厚度�
Vogt-Koyanagi-Harada disease(VKH)is a rare,multisystem disease of melanocyte-containing organs.It is characterized by diffuse,granulomatous inflammation involving various organs.It has been reported to occur in association with other autoimmune disorders.We report the case of a female patient who was diagnosed with VKH at the age of 4 years and who was treated with corticosteroids until the age of 16.Twenty years later,Crohn’s disease was diagnosed,with a severe flare-up.Three cases of VKH associated with ulcerative colitis have previously been reported anecdotally but,to our knowledge,this is the first case occurring in association to Crohn’s disease.
Ahlem SouguirAya HammamiWafa DahmeniHanene JaziriImed Ben MansourAhlem ZayeneAida Ben SlamaMehdi KsiaaAhlem BrahemSalem AjmiAli Jmaa
