表现为后部缺血性视神经病变的巨细胞动脉炎1例报道 Giant Cell Arteritis Manifests as Posterior Ischemic Optic Neuropathy: A Case Report

Abstract

巨细胞动脉炎是一种系统性肉芽肿性血管炎，主要侵犯颞浅动脉和眼动脉。以新近出现头痛、视觉症状和下颌运动障碍三联征为典型表现。巨细胞动脉炎可对视功能造成严重损害，因此是神经眼科急症，激素冲击疗法为其主要治疗方法。本文介绍了1例罕见的表现为后部缺血性视神经病变的巨细胞动脉炎患者，对其临床表现、实验室检查、影像学检查等进行综合分析，提示对于严重视力下降伴有疼痛的老年患者，视神经无水肿、萎缩表现的，应考虑此诊断。 Abstract: Giant cell arteritis (GCA) is a systemic granulomatous vasculitis that mainly affects the superficial temporal artery and the ophthalmic artery. The typical manifestation is the triad of headache, visual symptom and mandibular movement disorder. It is a neuro-ophthalmic emergency since it can cause profound visual loss. Hormone pulse therapy is the mainstay of treatment. This paper presents a rare GCA patient manifests as posterior ischemic optic neuropathy, and makes a comprehensive analysis of its clinical manifestations, laboratory examination and imaging examination. This case suggests that the diagnosis of GCA should be taken into account for elderly patients with severe vision loss accompanied by headache and no edema or atrophy in the optic nerve.

Keywords

• 巨细胞动脉炎
• 后部缺血性视神经病变
• 头痛; 视觉症状
• 下颌运动障碍
• giant cell arteritis
• posterior ischemic optic neuropathy
• headache
• visual symptom
• mandibular movement disorder