敬請指教

本人才疏學淺,懇請諸位先進前輩不吝指正。歡迎光臨:空中視力保健室

2007年7月29日 星期日

Uveitis記憶題整理

沒有vitritis者:OHS, ARPE, PORN
不侵犯chorioretinal vessel者: SO, PORN

White Dot Syndrome中幾乎都是雙側,只有兩種是單側: MEWDS, ARPE

成人最常見的ant. uvetiis: HLA B-27 related AAU
兒童最常見的ant. uvetiis: JRA
常見的post. uveitis: toxoplasmosis
兒童最常見的post. uveitis: toxoplasmosis

特別會造成高眼壓的uveitis:HSV, Posner-Schlosemann, toxoplasmosis


* 會有hypopyon的uveitis: Behcet, AAU
* 會有hypopyon的疾病:
1. endophthalmitis (post-op, traumatic, bleb-related, fugal, bacterial, endogenous …)
2. leukemia(包括Maquerade syndrome secondary to leukemia)
3. bacterial keratitis/ corneal ulcer
4. Rifabutin induced uveitis
5. Topical anesthetic abuse

* 不會有hypopyon的疾病: VKH等。


白內障手術:

* 開cataract手術很少complication,prognois好uveitis
=> Fuchs heterochromic iridocyclitis

* JRA患者開Cataract手術一般會做lensectomy+vitrectomy,術前要control inflammation,術前一周要用oral steroids及topical steroids來預防CME及PCO。
=> 對於young child有人建議不要放IOL,因為很容易在IOL附近出現fibrous membrane及CME。
=> 但大一點的小孩,可以在較強的anti-inflammatory agents下完成IOL implant。
=> 不放IOL,就得考量aphakia下amblyopia的可能。
=> 若有band keratopathy,可在術前以EDTA治療。


最常造成PORN的病因→VZV

MEWDS會有enlarged blind spot

toxacaria granuloma→TH2 delayed hypersensitivity

Sarcoidosis很少會有retinal hemorrhage

ankylosing spondylitis與episcleritis/scleritis無關

1 則留言:

匿名 提到...

JRA cataract surgery 是比較多 complication的:
Patients with JRA-associated iridocyclitis present some of the most difficult management problems of all uveitis cases with respect to cataract removal. Conventional cataract extraction is associated with a high rate of complications in these patients.

At this time, most authorities agree that IOL implantation is generally contraindicated in younger children with JRA-associated iridocyclitis because of the severity of the inflammation in these patients

PS. White dot syndrome 寫的太精采了!
:)