伴虹膜异色的青光眼睫状体炎综合征与Fuchs综合征的鉴别诊断——附3例临床报告

Differential diagnosis of the Posner Schlossman's syndrome with heterochromic iris and the Fuchs syndrome——clinial report about three cases

目的:对比分析伴虹膜异色的青光眼睫状体炎综合征与Fuchs综合征患者的临床表现及特点,对两种疾病的鉴别要点作出分析及总结,利于临床医生对这两种疾病进行鉴别诊断。方法:对本院自2000年至今收治住院的3例伴虹膜异色的青光眼睫状体炎综合征(Posner-Schlossman’s syndrome,PSS)患者进行详细的临床检查及研究,根据其临床资料总结出该病的临床特点,并对伴虹膜异色的PSS与Fuchs综合征的鉴别要点作出分析及总结。结果:共收集了3例伴虹膜异色的PSS患者,均为单眼反复发病,病程均在10a以上,发作时眼压明显升高,可达30.00～60.00mmHg,持续时间一般为3～7d,可自行缓解或用药后缓解,间歇期眼压正常,该3例患者除了具有典型的PSS表现外,虹膜均轻度异色。总结了该病在发作期及间歇期的临床表现,从发病情况、眼压波动情况、KP形态、晶状体情况、眼底及视功能情况详细论述了伴虹膜异色的青光眼睫状体炎综合征与Fuchs综合征的区别,并针对两种疾病的治疗提出了不同建议。结论:结合我们所提出的鉴别要点,对患者进行详细的临床检查,可以对这两种疾病进行鉴别诊断。

AIM：To analyze the clinical manifestations and characteristics of the Posner Schlossman＇s syndrome（PSS） with heterochromic iris and the Fuchs syndrome in patients and to summarize the main points of the two diseases for differential diagnosis.·METHODS：We collected the clinical data about 3 cases of PSS with heterochromic iris who were treated in our hospital from 2000 to now. Detailed clinical examination and research had been made on these patients. According to the clinical data,we summarized the clinical features of this disease. Further more,we analyzed and summaried the main points of the two diseases for differential diagnosis.·RESULTS：The clinical data of the three PSS cases with heterochromic iris were collected. The three patients all had the history of repeated incidence of monocular,and the course of the disease was more than 10 years. The intraocular pressure could increase up to 30 to 60 mmHg when the disease attacked,the duration was generally 3 to 7 days. It could spontaneous cure or alleviate after medication. The intraocular pressure was mormal in intermittent periods. The three patients all had the typical clinical manifestations of PSS,and they all had mild heterochromic iris. We summarized the clinical manifesta-tions of the disease in the period at onset and in intermittent period. From the characteristics of incidence of the two diseases,the intraocular pressure fluctuations,different forms of KP,the len condition,different conditon of fundus and visual function,we discussed in detail the difference between PSS with heterochromic iris and Fuchs syndrome,and putted forward various proposals for treatment of the two diseases.·CONCLUSION：Combination of the main points of the two diseases for differential diagnosis with detailed clinical examination can be used for differential diagnosis of the two diseases.