虹膜结核性肉芽肿1例
Tuberculous granuloma of the iris: a case report
摘要
1例右眼红伴视力下降14 d的29岁男性患者就诊于南通大学附属医院眼科。右眼裸眼视力为0.02（矫正不提高），羊脂状角膜后沉着物，前房闪光（++），可见2个虹膜肿物。因全身体检高度怀疑为颈部淋巴结结核，行诊断性全身抗结核治疗1个月后复查眼科，虹膜原肿物缩小，但出现新发结节，临床诊断为右眼虹膜结核性肉芽肿，行右眼虹膜肿物切除术。术后虹膜肿物组织病理学检查结果为肉芽肿性结节伴慢性炎症细胞浸润，玻璃体液PCR检测结果为结核分枝杆菌 DNA阳性，病理学诊断为右眼虹膜结核性肉芽肿。继续全身抗结核治疗后，右眼最佳矫正视力恢复至0.8，眼内无炎性反应。
A 29-year-old man presented to Department of Ophthalmology, Affiliated Hospital of Nantong University with a 14-day history of redness and decreased vision in the right eye. Uncorrected visual acuity in the right eye was 0.02 (not improvable with correction). Slit-lamp examination revealed mutton-fat keratic precipitates on the corneal endothelium, anterior chamber inflammation, and two iris masses. Systemic evaluation suggested cervical lymph node tuberculosis, and empirical anti-tuberculosis therapy was initiated. After one month of treatment, the original iris lesion regressed, but new nodules developed. A diagnosis of iris tuberculous granuloma was suspected, and surgical excision of the iris lesions was performed. Histopathological examination demonstrated granulomatous nodules with chronic inflammatory cell infiltration. Furthermore, polymerase chain reaction analysis of vitreous fluid was positive for Mycobacterium tuberculosis DNA, confirming the diagnosis of iris tuberculous granuloma. Following continued systemic anti-tuberculosis therapy, the best-corrected visual acuity improved from 0.02 to 0.8, and the intraocular inflammation was completely controlled.
年，卷(期)：
2026, 62(10)
在线出版日期：
2026年10月11日
