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Diagnostic and therapeutic challenges.

机译:诊断和治疗挑战。

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A 42-year-old man presented with gradual painless progressive diminution of vision in both eyes of 3-month duration. Three months earlier to the onset of visual symptoms, he was diagnosed to have renal failure with systemic hypertension and hyperuricemia. He was started on allopurinol and oral steroids along with antihypertensive medication. While on treatment, he developed an allergic reaction to allopurinol, which resulted in Stevens-Johnson syndrome. At presentation, he was on oral steroids and antihypertensive drugs. On examination, there was no perception of light in the right eye and 20/160 in the left eye. Anterior segment examination of both the eyes was unremarkable, except for the presence of dry eyes. Fundus examination of both the eyes showed 1+ vitreous cells. The right eye had a pale disk with sclerosed vessels and confluent chorioretinal scars throughout the retina (Figure 1). The left eye revealed multiple patches of active and healed chorior-etinitis with few areas of vasculitis.
机译:一名42岁的男子在3个月的持续时间内双眼逐渐无痛性视力递减。视觉症状发作三个月前,他被诊断患有系统性高血压和高尿酸血症的肾衰竭。他开始服用别嘌醇和口服类固醇以及降压药。在治疗期间,他对别嘌醇产生了过敏反应,导致史蒂文斯-约翰逊综合征。在演讲中,他正在服用口服类固醇和降压药。检查时,右眼没有光线,左眼没有20/160。除存在干眼外,双眼的前节检查无异常。两只眼睛的眼底检查显示1+玻璃体细胞。右眼的椎间盘苍白,血管硬化,在整个视网膜上融合了脉络膜视网膜瘢痕(图1)。左眼显示出多处活跃且已治愈的绒毛膜性视网膜炎,血管炎区域很少。

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