摘要目的 观察不合并眼外病灶拟诊为脉络膜结核瘤的临床特征及治疗效果.方法 选择2009年1月至2014年1月于河北省眼科医院就诊的脉络膜结核瘤患者5例5只眼,行最佳矫正视力、裂隙灯显微镜、前置镜、荧光素眼底血管造影、频域光相干断层扫描、眼部B超等检查,同时行胸部X线片、血液学检查、结核菌素皮肤试验(TST)等检查.所有患者行全身抗结核治疗,随访时间9～13个月,平均10.75个月.结果 患者初诊最佳矫正视力为0.04～0.15.5只眼中,均无前节炎症;玻璃体可见炎性细胞3只眼,其中玻璃体明显混浊1只眼;眼底检查:5只眼均可见视网膜下黄白色病灶,约1～3PD,视网膜下硬性渗出,渗出性视网膜脱离.荧光素眼底血管造影(FFA):4只眼表现为早期病变区不规则形低荧光,晚期强荧光染色,视盘强荧光着色;1只眼早期局部荧光略强,边缘渗漏,晚期强荧光.结核菌素皮肤试验(TST)强阳性5例,均未发现眼外结核灶.经规范化抗结核药物治疗,随访期末,炎症均控制.最佳矫正视力:0.12～0.8.结论 脉络膜结核瘤可不合并眼外病灶,主要表现为后极部视网膜下黄白色病灶及渗出性视网膜脱离,规范化的抗结核治疗,可以控制感染.

abstractsObjective To observe the features and treatment outcomes of presumed choroidal tuberculoma not combined the else lesions.Methods The 5 cases (5 eyes) with choroidal tuberculosis patients in Hebei province hospital between January 2009 and January 2014.Best corrected visual acuity,slit lamp ophthalmoscopy,fundus fluorescein angiography (FFA),optical coherence tomography (OCT),the B ultrasound and MRI,hematological and tuberculin skin test were examined.All patients had standard anti-tuberculosis treatment.Treatment outcomes were followed for 9 to 13 months with an average of 10.75 months.Results Baseline visual acuity ranged from 0.04 to 0.15.Among 5 eyes,no one presented anterior segment inflammation.Three presented vitritis,one was obvious.Fundus examination showed five eyes with subretinal yellow-white lesions,retinal hard exudates and exudative retinal detachment.FFA revealed four eyes hypofluorescence in the early stage and hyperfluorescence in the late stage.TST of five patients were all strong positive.Extraocular tuberculous lesions were not found.After standard anti-tuberculosis treatment,inflammation was controlled at the end of follow-up.Best corrected visual acuity ranged from 0.12 to 0.8.Conclusions Choroidal tuberculoma can not associate with extraocular lesions.The main presentations of presumed choroidal tuberculoma are subretinal yellow-white lesions at the posterior pole,retinal hard exudates and exudative retinal detachment.Standard anti-tuberculosis treatment can improve Inflammation.