中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
19期
1317-1320
,共4页
虹膜角膜内皮综合征%虹膜炎%诊断,鉴别%Axenfeld-Rieger综合征
虹膜角膜內皮綜閤徵%虹膜炎%診斷,鑒彆%Axenfeld-Rieger綜閤徵
홍막각막내피종합정%홍막염%진단,감별%Axenfeld-Rieger종합정
Iridocomeal endothelial syndrome%Irits%Diagnosis,differential%Axenfeld Rieger syndrome
目的 分析双眼虹膜角膜内皮综合征病例误诊原因.方法 以回顾性病例系列研究分析北京同仁医院眼科中心自1998年1月至2011年12月期间接诊的误诊双眼双眼虹膜角膜内皮(ICE)综合征病例,同时检索1982-2011年国内公开报道的双眼ICE综合征的病例.对其病史、主要症状以及角膜、虹膜、房角等资料加以分析,并将ICE综合征与易于之混淆的Axenfeld-Rieger综合征、后部多形性角膜营养不良及陈旧性虹膜炎的临床表现及体征进行对比,分析导致误诊双眼ICE综合征的原因.结果 我院曾经接诊诊断双眼ICE综合征病例共10例,20只眼,最终确诊Axenfeld-Rieger综合征5例,后部多形性角膜营养不良2例,陈旧性虹膜炎3例.检索的国内文献中双眼ICE综合征报道共9篇,记录患者18例.对其资料分析显示:10例患者不能排除Axenfeld-Rieger综合征,2例患者不能排除后部多形性角膜营养不良,6例患者病例资料缺失,不能进一步判断.结论 双眼发病ICE综合征病例多为误诊,我们检索的国内病例报告中,尚难确定存在双眼ICE综合征病例.角膜内皮细胞特征性改变,特别是角膜内皮镜检查发现ICE细胞,是ICE综合征确诊依据,也是鉴别Axenfeld-Rieger综合征、后部多形性角膜营养不良及陈旧性虹膜炎等疾病的重要依据.
目的 分析雙眼虹膜角膜內皮綜閤徵病例誤診原因.方法 以迴顧性病例繫列研究分析北京同仁醫院眼科中心自1998年1月至2011年12月期間接診的誤診雙眼雙眼虹膜角膜內皮(ICE)綜閤徵病例,同時檢索1982-2011年國內公開報道的雙眼ICE綜閤徵的病例.對其病史、主要癥狀以及角膜、虹膜、房角等資料加以分析,併將ICE綜閤徵與易于之混淆的Axenfeld-Rieger綜閤徵、後部多形性角膜營養不良及陳舊性虹膜炎的臨床錶現及體徵進行對比,分析導緻誤診雙眼ICE綜閤徵的原因.結果 我院曾經接診診斷雙眼ICE綜閤徵病例共10例,20隻眼,最終確診Axenfeld-Rieger綜閤徵5例,後部多形性角膜營養不良2例,陳舊性虹膜炎3例.檢索的國內文獻中雙眼ICE綜閤徵報道共9篇,記錄患者18例.對其資料分析顯示:10例患者不能排除Axenfeld-Rieger綜閤徵,2例患者不能排除後部多形性角膜營養不良,6例患者病例資料缺失,不能進一步判斷.結論 雙眼髮病ICE綜閤徵病例多為誤診,我們檢索的國內病例報告中,尚難確定存在雙眼ICE綜閤徵病例.角膜內皮細胞特徵性改變,特彆是角膜內皮鏡檢查髮現ICE細胞,是ICE綜閤徵確診依據,也是鑒彆Axenfeld-Rieger綜閤徵、後部多形性角膜營養不良及陳舊性虹膜炎等疾病的重要依據.
목적 분석쌍안홍막각막내피종합정병례오진원인.방법 이회고성병례계렬연구분석북경동인의원안과중심자1998년1월지2011년12월기간접진적오진쌍안쌍안홍막각막내피(ICE)종합정병례,동시검색1982-2011년국내공개보도적쌍안ICE종합정적병례.대기병사、주요증상이급각막、홍막、방각등자료가이분석,병장ICE종합정여역우지혼효적Axenfeld-Rieger종합정、후부다형성각막영양불량급진구성홍막염적림상표현급체정진행대비,분석도치오진쌍안ICE종합정적원인.결과 아원증경접진진단쌍안ICE종합정병례공10례,20지안,최종학진Axenfeld-Rieger종합정5례,후부다형성각막영양불량2례,진구성홍막염3례.검색적국내문헌중쌍안ICE종합정보도공9편,기록환자18례.대기자료분석현시:10례환자불능배제Axenfeld-Rieger종합정,2례환자불능배제후부다형성각막영양불량,6례환자병례자료결실,불능진일보판단.결론 쌍안발병ICE종합정병례다위오진,아문검색적국내병례보고중,상난학정존재쌍안ICE종합정병례.각막내피세포특정성개변,특별시각막내피경검사발현ICE세포,시ICE종합정학진의거,야시감별Axenfeld-Rieger종합정、후부다형성각막영양불량급진구성홍막염등질병적중요의거.
Objective To analyze the misdiagnosis of bilateral iridocorneal endothelial (ICE) syndrome and the possible reasons.Methods The patients seen from January 1998 to December 2011 at Beijing Tongren Hospital,misdiagnosed as bilateral ICE syndrome,were analyzed retrospectively.And a literature search was performed with a Wanfang computerized database website for the case studies of bilateral ICE syndrome.The history,clinical profiles and the findings of corneal,iris and anterior chamber examinations were analyzed.The clinical manifestations of patients with ICE syndrome were also compared with those of Axenfeld-Rieger syndrome,posterior polymorphous dystrophy (PPMD) and chronic iritis for differential diagnosis.Results Ten patients were diagnosed as bilateral ICE syndrome.However,among them,5 patients were diagnosed as Axenfeld-Rieger syndrome,2 patients as PPMD,3 as chronic iritis and none as bilateral ICE syndrome.There were 9 Chinese reports of bilateral ICE syndrome in a total of 18 patients.Analysis showed that Axenfeld-Rieger syndrome needed to be ruled out in 10 patients,PPMD could not be ruled out in 2 patients while diagnosis could not be made in 6 patients for a lack of proof.Conclusion Despite the reporting of bilateral cases,ICE syndrome is usually unilateral.With specific micrographic features for a definite diagnosis of ICE syndrome,ICE cells may become an important feature differentiating from Axenfeld-Rieger syndrome,PPMD and chronic iritis.
