2023年 · 第59卷第05期

The patient was a 55-year-old male. He was admitted to the Department of Ophthalmology of Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine for 8 years due to decreased visual acuity in his right eye and eye pain. Five years ago, he underwent phacoemulsification and cataract aspiration of the left eye combined with anterior peripheral vitrectomy in this hospital. Eye examination: visual acuity is light sensing in the right eye and 0.2 in the left eye; IOP was 52 mmHg (1 mmHg =0.133 kPa) in the right eye and 16 mmHg in the left eye; Adhesive deformation of the right eye pupil with a small amount of new blood vessels, opacity of the lens, and unclear vision of the fundus; The left eye has a round pupil, absent lens, clear and white optic disc boundary, flat retina, sunset-like fundus changes, scattered Dalen-Fuchs nodules in the peripheral retina, and 6 vortex veins are clearly visible (Quintessential Picture 1). Clinical diagnosis: Fogt-Koyanagi-Harada syndrome (both eyes).

The patient was a 46-year-old female. He was admitted to the Department of Ophthalmology of Peking University International Hospital because his left eye visual acuity decreased for 3 months with orbital pain and aggravated for 2 weeks. Eye examination: naked eye visual acuity was 1.0 in the right eye and 20 cm manual in the left eye; IOP was 10 mmHg (1 mmHg =0.133 kPa) in the right eye and 12 mmHg in the left eye; Transparent cornea in both eyes, no retrocorneal sediment, deep anterior chamber, no anterior chamber flash, clear iris texture, round pupil, right eye pupil diameter 3 mm, sensitive to light, left eye pupil diameter 4 mm, showing relative afferent pupil dysfunction, transparent lens; There was no obvious abnormality in the retina of the right eye, edema above the nose of the optic disc and atrophy below the temporal in the left eye, ciliary shunt of the optic nerve on the surface of the optic disc, linear hemorrhage above the temporal of the optic disc, and no obvious abnormality in the macular area. Fluorescein fundus angiography of the left eye is shown in the essence picture 1. Enhanced orbital MRI examination: the optic nerve of the left eye showed a "double track" sign (Quintessential Picture 2), and space-occupying lesions were seen in the optic nerve sheath and anterior clinoid process. Clinical diagnosis: meningioma of the optic nerve sheath of the left eye.