年輕女性罹患單純前葡萄膜炎經由切片診斷為眼類肉瘤症

Biopsy-Proven Ocular Sarcoidosis Appearing Isolated Anterior Uveitis in a Young Woman

本文宗旨：報告一位年輕女性呈現兩側眼內前房Koeppe結節，後房沒有影響。經由切片病理診斷為確定的眼類肉瘤症。方法：回顧性病例報告。結果：38歲女性因為全身無力合併輕微胸痛被送入急診室，評估後並無感染或心臟疾病，經由支持療法舒緩。一周後病患開始雙眼視力模糊，最佳矯正視力為雙眼6/30，檢查發現兩側眼內呈現特殊的前房Koeppe結節，後房沒有影響。使用三到四周局部和口服類固醇藥物後，眼睛視力逐漸好轉到雙眼6/6.7，雙眼前房無發炎，經由淋巴結切片呈現典型病理結果診斷為眼類肉瘤症。結論：眼類肉瘤症以單純呈現前房葡萄膜炎是不容易診斷的，並且要經由病理切片證實就更少了。年輕女性兩側眼內呈現特殊的前房Koeppe結節，在臨床上必須瞭解為包括眼類肉瘤症的肉芽性前葡萄膜炎症，並正確診斷治療。

Background and purpose: To report a young lady presenting bilateral unique Koeppe’s nodules without posterior involvement. Definite ocular sarcoidosis was diagnosed by biopsy-proven pathology. Methods: A retrospective case report. Results: A 38-year-old lady was sent to the emergency department because of general weakness and mild chest pain, and relief by supportive treatment without evidence of infectious activities or cardiac diseases. One week later, she complained of blurred vision OU presenting with bilateral distinct Koeppe’s nodules and no posterior involvement. Best-corrected visual acuity was 6/30 OU. Topical and systemic corticosteroids were administrated for 3-4 weeks, and vision improved to 6/6.7 OU with the silent anterior chamber in both eyes. Ocular sarcoidosis was proven by lymph nodules biopsy with classic pathologic findings. Conclusions: Ocular sarcoidosis with isolated anterior uveitis is difficult to diagnose and seldom undergo biopsy with evidence of pathologic findings. Bilateral unique Koeppe’s nodules appeared in a young lady, and clinicians should be aware of granulomatous anterior uveitis including ocular sarcoidosis.