病例报告：系统性红斑狼疮继发单眼Purtscher样视网膜病变：低疾病活动度下的临床特征分析
Case Report: Monocular Purtscher-like retinopathy secondary to systemic lupus erythematosus: analysis of clinical characteristics under low disease activity.
摘要(中文译文)
本研究旨在报道一例继发于系统性红斑狼疮（SLE）的单侧类Purtscher视网膜病变（PLR），并探讨其临床特征、诊断及治疗转归。回顾性分析一例23岁女性SLE患者的临床资料，包括病史、眼科检查、视力、眼底评估、光学相干断层扫描（OCT）、眼底荧光素血管造影（FFA）、实验室检查及治疗随访结果。患者因左眼急性视力下降2天余入院，有8年SLE病史。临床表现为左眼Purtscher斑及视网膜微循环异常。初诊左眼视力为0.05（矫正无提高）。眼底检查显示沿血管走行分布的Purtscher斑，OCT显示黄斑区内层视网膜高反射，FFA证实为PLR。实验室检查提示红细胞沉降率升高（109.00 mm/h）、免疫球蛋白G升高（34.88 g/L），SLE疾病活动指数评分为4分（低疾病活动度）。治疗包括醋酸泼尼松联合环磷酰胺控制原发病、谷红注射液改善循环、球周注射复方樟柳碱联合甲钴胺营养神经，以及激光光凝治疗黄斑无灌注区。治疗11天后，左眼视力提高至0.25，症状缓解；1个月随访显示Purtscher斑减少，黄斑高反射改善，视力稳定。PLR是SLE罕见的眼部并发症，即使在低疾病活动度期间也可发生。早期诊断并结合原发病控制、微循环改善及激光治疗可有效改善视力预后，凸显了对SLE患者进行定期眼底筛查的重要性。
Abstract
This study aims to report a case of unilateral Purtscher-like retinopathy (PLR) secondary to systemic lupus erythematosus (SLE) and explore its clinical features, diagnosis, and therapeutic outcomes. A retrospective analysis was performed on the clinical data of a 23-year-old female SLE patient, including medical history, ophthalmic examinations, visual acuity, fundus assessment, optical coherence tomography (OCT), fundus fluorescein angiography (FFA), laboratory tests, and treatment follow-up results. The patient was admitted with acute left eye vision loss for over 2 days and had an 8-year history of SLE. Clinical manifestations included left eye Purtscher flecken and retinal microcirculatory abnormalities. The initial left eye visual acuity was 0.05 (no improvement with correction). The fundus examination revealed Purtscher flecken along vascular tracts, OCT showed hyperreflectivity in the inner macular retina, and FFA confirmed PLR. The laboratory tests indicated elevated erythrocyte sedimentation rate (109.00 mm/h), increased immunoglobulin G (34.88 g/L), and a SLE Disease Activity Index score of 4 (low disease activity). The treatment included prednisone acetate combined with cyclophosphamide for primary disease control, Guhong Injection for circulatory improvement, peribulbar injection of compound anisodine combined with methylcobalamin for neuroprotection, and laser photocoagulation for macular non-perfusion areas. After 11 days of treatment, the left eye visual acuity improved to 0.25 with symptom relief; the 1-month follow-up showed reduced Purtscher flecken, improved macular hyperreflectivity, and stable vision. PLR is a rare ocular complication of SLE that can occur even during low disease activity. Early diagnosis combined with primary disease control, microcirculatory improvement, and laser therapy can effectively improve visual prognosis, highlighting the importance of regular fundus screening for SLE patients.
如何引用
AMA
Xiaodong Li, Min Liu. Case Report: Monocular Purtscher-like retinopathy secondary to systemic lupus erythematosus: analysis of clinical characteristics under low disease activity.. Frontiers in immunology. 2026; doi:10.3389/fimmu.2026.1715542.
APA
Xiaodong Li, Min Liu (2026). Case Report: Monocular Purtscher-like retinopathy secondary to systemic lupus erythematosus: analysis of clinical characteristics under low disease activity.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2026.1715542
GB/T 7714
Xiaodong Li, Min Liu. Case Report: Monocular Purtscher-like retinopathy secondary to systemic lupus erythematosus: analysis of clinical characteristics under low disease activity.[J]. Frontiers in immunology, 2026 doi:10.3389/fimmu.2026.1715542.
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