误诊为中浆及视网膜炎的后巩膜炎1例并文献复习

doi:10.6040/j.issn.1673-3770.0.2025.286

摘要/Abstract

摘要： 目的探讨后巩膜炎的病因、发病机制、临床表现、诊疗思维,主要探讨鉴别诊断、治疗方法及预后,以便对其进行早期确诊,避免误诊漏诊。方法回顾性分析1例后巩膜炎患者的临床资料,总结分析本病例的诊疗过程及临床思维,并进行文献复习。结果患者历时8年,经过多次误诊,最终于我院确诊并在正确治疗1周后,右眼最佳矫正视力由0.12提高到0.30,视网膜在位,视盘水肿及黄斑区水肿较前明显减轻。1月后右眼矫正视力恢复至0.60。结论后巩膜炎临床表现多样,易误诊为中心性浆液性脉络膜视网膜病变、视网膜炎等疾病。详细的问诊及仔细的查体,有助于提高后巩膜炎早期确诊率,避免误诊误治。

关键词: 后巩膜炎, 中心性浆液性脉络膜视网膜病变, 视网膜炎, 视盘水肿, 黄斑水肿

Abstract: Objective The aim is to investigate the etiology, pathogenesis, clinical manifestations, diagnostic and treatment methods of posterior scleritis, with a focus on differential diagnosis, treatment strategies, and prognosis. Methods A retrospective analysis of a patient with posterior scleritis was conducted, along with literature review, to summarize the diagnostic and therapeutic processes. Results Numerous misdiagnoses given to the patient over eight years were finally rectified. After one week of appropriate treatment, the best-corrected visual acuity(BCVA)in the right eye improved from 0.12 to 0.30, with a significant reduction in optic and macular edema. One month afterwards, the BCVA in the right eye further stabilized at 0.60. Conclusion Posterior scleritis can present with diverse clinical manifestations, potentially leading to misdiagnosis such as central serous chorioretinopathy or retinitis. A detailed medical history and thorough physical examination can significantly improve the early diagnosis accuracy, thereby preventing misdiagnosis and inappropriate treatment.

Key words: Posterior scleritis, Central serous chorioretinopathy, Retinitis, Optic disc edema, Macular edema

中图分类号:

R772.3

朱云龙,王平,高萌. 误诊为中浆及视网膜炎的后巩膜炎1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 99-105.

ZHU Yunlong, WANG Ping, GAO Meng. A case of posterior scleritis initially misdiagnosed as central serous chorioretinopathy and retinitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(1): 99-105.

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