维莫菲尼治疗转移性黑色素瘤致VKH综合征1例  

Vogt-Koyanagi-Harada syndrome in the setting of vemurafenib therapy for metastatic melanoma: a case report

作　　者：任晓彤 郭彤[1] 杨帆[1] 吴文雨 窦宏亮[1] 李学民[1] Ren Xiaotong;Guo Tong;Yang Fan;Wu Wenyu;Dou Hongliang;Li Xuemin(Department of Ophthalmology,Peking University Third Hospital,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve,Beijing 100191,China)

机构地区：[1]北京大学第三医院眼科眼部神经损伤的重建保护与康复北京市重点实验室,北京100191

出　　处：《中华眼科杂志》2022年第11期925-928,共4页Chinese Journal of Ophthalmology

摘　　要：1例53岁双眼视物模糊10余天女性患者, 既往因腹股沟淋巴结转移性恶性黑色素瘤口服靶向药物维莫菲尼。检查发现左眼房水闪光, 视盘水肿, 双眼黄斑区神经上皮脱离, 荧光素眼底血管造影术检查示早中期点状强荧光, 晚期渗漏荧光呈多湖状, 诊断为双眼福格特-小柳-原田综合征(VKH综合征)。眼部使用糖皮质激素治疗, 并在肿瘤科指导下间断服用维莫菲尼至停药。治疗后双眼视力改善, 眼前节炎性反应消退, 视网膜神经上皮复位, 色素上皮脱色素呈晚霞样眼底。A 53-year-old female patient complained of 1 week of bilateral visual blurring.She was previously diagnosed with metastatic melanoma of the inguinal lymph nodes and treated with the oral targeted drug vemurafenib.She exhibited aqueous flare in the left eye,and her fundus examination revealed optic disc swelling in the left eye and bilateral serious detachment of the retinal neuroepithelial layer.Fluorescein angiography showed multiple pinpoint hyperfluorescence leakage spots in the prometaphase and appeared as multilobular dye pooling in the late phase.We diagnosed her as Vogt-Koyanagi-Harada syndrome and gave glucocorticoid treatment for eyes.Oral vemurafenib was also taken intermittently under the guidance of an oncologist.After treatment,her bilateral vision improved,the anterior segment inflammation disappeared,and the retinal neuroepithelial layer reattached,with presence of the"sunset glow"fundus.

关 键 词：黑色素瘤 淋巴转移 维莫非尼 葡萄膜脑膜脑炎综合征 

分 类 号：R739.7[医药卫生—肿瘤]