Pseudohyphema

Introduction The anterior chamber empyema caused by intraocular tumors is also called pseudo anterior chamber empyema. Because its clinical manifestation resembles endophthalmitis, it is also called camouflage syndrome.

Cause

Common tumors that cause pseudo anterior chamber empyema include leukemia, lymphoma, retinoblastoma, choroidal melanoma, and metastatic intraocular tumors.

an examination

Related inspection

General examination of the anterior chamber of the CT examination in the eye and sac

Anterior chamber puncture pathology and pathogenic examination can help confirm the diagnosis, but may need to be repeated several times until there is a positive finding. Although chalk and strabismus are the most common clinical manifestations of retinoblastoma, uncommon clinical manifestations such as ocular protrusion, sputum cellulitis, pseudo anterior chamber empyema, and anterior chamber/vitreous hemorrhage are more likely to lead to misdiagnosis. Retinoblastoma can be divided into exogenous, endogenous and invasive types, of which invasive type only accounts for 1.5%. The clinical manifestations are diffuse retinal thickening, no obvious mass, and rarely calcification. Pseudo anterior chamber empyema, anterior chamber hemorrhage, or eyelid inflammation, often misdiagnosed as endophthalmitis or cellulitis. It has been reported that pseudo-anterior chamber empyema as the first manifestation of retinoblastoma accounts for about 2 to 8%, mostly invasive, no family history, single eye disease, the average age of onset is 6 years old.

Differential diagnosis

Differential diagnosis of pseudo anterior chamber empyema:

In order to be able to diagnose early, clinical identification of true and pseudo anterior empyema is essential. The main identification points are: pseudo anterior chamber empyema is more common in children and middle-aged and elderly people. Chronic course, empyema is mostly white snowflake, not sticky, fluid level can change with body position, fundus examination or B-ultrasound imaging examination There is a positive change, the systemic examination may be abnormal, and true anterior chamber empyema is more common in young adults, short course, pus viscous, no obvious abnormalities in the fundus, systemic examination may have specific changes in anterior chamber pathology and etiology The examination can help confirm the diagnosis, but it may need to be repeated several times until there is a positive finding.

Although chalk and strabismus are the most common clinical manifestations of retinoblastoma, uncommon clinical manifestations such as ocular protrusion, sputum cellulitis, pseudo anterior chamber empyema, and anterior chamber/vitreous hemorrhage are more likely to lead to misdiagnosis. Retinoblastoma can be divided into exogenous, endogenous and invasive types, of which invasive type only accounts for 1.5%. The clinical manifestations are diffuse retinal thickening, no obvious mass, and rarely calcification. Pseudo anterior chamber empyema, anterior chamber hemorrhage, or eyelid inflammation, often misdiagnosed as endophthalmitis or cellulitis. It has been reported that pseudo-anterior chamber empyema as the first manifestation of retinoblastoma accounts for about 2 to 8%, mostly invasive, no family history, single eye disease, the average age of onset is 6 years old.

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