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題名 | 眼眶部偽腫瘤--病例報告=Orbital Pseudotumor--A Case Report |
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作者 | 林義博; 沈劍西; 尤之浩; | 書刊名 | 中華民國眼科醫學會雜誌 |
卷期 | 38:2 1999.06[民88.06] |
頁次 | 頁291-296 |
分類號 | 416.752 |
關鍵詞 | 眼眶部偽腫瘤; Orbital pseudotumor; Proptosis; |
語文 | 中文(Chinese) |
中文摘要 | 本篇報告一例16歲女性,初期左眼瞼紅腫,二天後,出現複視、凸眼( proptosis)而轉送至本院求治。眼科理學檢查發現,左眼上下眼瞼紅腫,內下斜視併有 5mm的凸眼,電腦斷層顯示左跟上直肌及上眼瞼提肌肥大。生化免疫檢查均正常。初步診 斷為眼眶偽腫瘤後,以高劑量類固醇(prednisolone 8Omg/day)口服投與治療,第二天症 狀明顯改善,經過一星期後症狀完全改善,經檢查一切正常,不過仍以高劑量類固醇( prednisolone8Omg/day)持續治療至三星期。連續三星期後,劑量以每星期2Omg漸減,六 星期後停藥,追蹤三個月內病人無復發現象。 眼科有些不具特異性的症狀往往是有視力威脅及嚴重疾病的前兆,我們不可輕忽並要 追蹤其變化以免錯失治療之良機及避免醫療糾紛。 |
英文摘要 | A 16-year-old girl was characterized by abrupt onset of pain, lid swelling and redness (OS), which bring her to the clinic. She initially received treatment under impression of allergic conjunctivitis. Unfortunately, the binocular diplopia and unilateral exophtlialmos developed two days later. Esotropia, hypodeviation but normal color vision was also noted. Best V.A. correction was always up to 1.0. Cornputed toinography wit contrast enhancement revealed swelling or hypertrophy of left levator muscle and left superior rectus muscle. Lab. Tests including thyroid function test, ANA, RF, VDRL test, ESR, CBC/DC and blood sugar were all normal. High-dose oral predilisoi6ne 80mglday as initial dose used for 3 weeks. Patient had marked symptomatic improvement within 48 hours of starting treatmerit. The dosage of prednisolone was tapered by 20 mg per week. The patient was fully recovered after prednisolone treatment regiment. From the experience of this case, we learned that the non-specific symptom such as lid swelling might be the initial presentation of more serious diseases. Thus, we should carefully inspect patients at their first visit in spite of common symptoms/signs and well explain the potential risk to avoid the serious complications or even legal problems. |
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