特发性葡萄膜渗漏综合征误诊原因分析  

Misdiagnosed Analysis of Idiopathic Uveal Effusion Syndrome

作　　者：沈志军 沈琳 王红 SHEN Zhi-jun;SHEN Lin;WANG Hong(Beijing Tongren Eye Center Beijing Key Laboratory Ophthalmology and Visual Science,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院,北京同仁眼科中心,眼科学与视觉科学北京市重点实验室,北京100730

出　　处：《临床误诊误治》2022年第4期17-20,共4页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨特发性葡萄膜渗漏综合征的临床误诊原因以及防范措施。方法回顾性分析2010年1月以来收治的特发性葡萄膜渗漏综合征29例36只患眼的临床资料。结果患者均因视力下降就诊,眼部检查显示单眼或双眼视网膜脱离。在36只患眼中,有4只患眼曾被误诊为葡萄膜炎,2只患眼曾被误诊为中心性浆液性脉络膜视网膜病变,1只患眼曾被误诊为孔源性视网膜脱离,1只患眼曾被误诊为特发性脉络膜新生血管。误诊率为22.2%(8/36),误诊时间1~6个月。眼部超声生物显微镜检查均有双眼睫状体渗漏。所有患眼均行四象限板层巩膜切除联合部分全层切除术,切除巩膜送病理检查,明确诊断为特发性葡萄膜渗漏综合征,视网膜脱离一般术后1周~5个月逐渐复位。结论掌握特发性葡萄膜渗漏综合征的临床特点,并结合相关的医技检查有助于正确诊断,及时手术有助于患者视力的恢复。Objective To investigate misdiagnosed causes and preventive measures of idiopathic uveal effusion syndrome(IUES).Methods A retrospective analysis was performed on clinical data of 29 patients(36 eyes)with IUES since January 2010.Results All patients with IUES saw a doctor for decreased vision.Ocular examinations showed retinal detachment in one or both eyes.Among the 36 affected eyes,4 eyes were misdiagnosed as uveitis;2 eyes were misdiagnosed as central serous chorioretinopathy;1 eye was misdiagnosed as rhegmatogenous retinal detachment,and 1 eye was misdiagnosed as idiopathic choroidal neovascularization.The misdiagnosis rate was 22.2%(8/36),and misdiagnosed duration was 1-6 months.Ultrasound biomicroscopy for ocular region showed the presence of binocular ciliary effusion.All the affected eyes underwent four-quadrant lamellar sclerectomy combined with partial full-thickness resection.Pathological examination was performed for the excised sclera,and then the diagnosis of IUES was confirmed.The retinal detachment was repositioned gradually after the surgery for 1 week to 5 months.Conclusion Grasping clinical characteristics of IUES combined with related auxiliary examinations is helpful for accurate diagnosis.and timely surgery will help patients recover their visions.

关 键 词：特发性葡萄膜渗漏综合征 视网膜脱离 误诊 葡萄膜炎 中心性浆液性脉络膜视网膜病变 

分 类 号：R773.9[医药卫生—眼科]