急性视网膜坏死

急性视网膜坏死是一种由疱疹类病毒感染引起的，以急性前葡萄膜炎、玻璃体炎、视网膜血管炎、视网膜坏死为主要特征的眼部综合征。本病起病急，进展快，预后极差。早期诊断和抗病毒药物治疗是改善急性视网膜坏死预后的关键。现代玻璃体视网膜显微手术对于挽救晚期患者的视功能具有重要的作用。 (中华眼底病杂志, 1999, 15: 165-267)     

急性视网膜坏死18例临床分析

目的 探讨急性视网膜坏死(acute retinal necrosis,ARN)的早期诊断和治疗方法.方法 回顾性研究18例21只眼急性视网膜坏死患者的临床表现和治疗方法.结果 17只眼玻璃体切除联合眼内硅油填充术,术后视网膜复位14只眼(82.35%),早期大剂量抗病毒药物治疗后单眼发病者未发现对侧眼发病.结论 尽早诊断和应用足量的抗病毒药物,结合预防性视网膜激光光凝和玻璃体切除术可提高急性视网膜坏死的治疗效果,同时减少对侧眼的发病率.     

急性视网膜坏死综合征的诊断与治疗

急性视网膜坏死综合征(acute retinal necrosis syndrome,ARNS)是由于病毒感染所引起的以急性坏死性视网膜炎、玻璃体炎、视网膜动脉炎以及后期伴发视网膜脱离等病变为特征的一种综合征,较少见,起病急,进展快,治疗困难,导致视功能严重受损。因此争取早期正确诊断与治疗的意义重大,我们就对ARNS的诊断及治疗的报道做一综述。     

急性视网膜坏死综合征的临床分析

目的 观察急性视网膜坏死综合征(ARN)的临床特征.方法 回顾性分析84例98只眼ARN患者的临床资料.患者进行了最佳矫正视力、眼压、B型超声检查、裂隙灯生物显微镜、前置镜、直接和(或)间接检眼镜结合三面镜检查,屈光间质清楚者行荧光素眼底血管造影.部分患者行聚合酶链反应(PCR)检查鉴定致病病毒种类,明确诊断ARN后抗病毒、选择性激光和玻璃体手术治疗.并对视力和眼底情况进行随访,平均随访时间24.1个月.结果 ANR患者平均发病年龄42.8岁,双眼发病率16.6%,视网膜脱离发生率57.1%.治疗后6个月和12个月以上视力高于0.02者分别为53.5%和35.5%.确诊时间在14 d内的ARN患眼以及双眼发病的继发眼预后较好.水痘-带状疱疹病毒是本组ARN的主要致病病毒,占62.5%;单纯疱疹病毒-1型ARN与脑炎等中枢神经系统疾病密切相关.结论 ARN急性起病,视网膜脱离发生率高,后期易出现严重视网膜血管病变,预后差.发病早期临床误诊多见,必要时可做PCR检查帮助明确诊断.     

急性视网膜坏死

急性视网膜坏死是由疱疹类病毒感染导致的一组综合征，主要包括急性葡萄膜炎、视网膜血管炎及视网膜坏死并脱离。目前已确诊其病原为水痘－带状疱疹病毒，以无环鸟苷为主的药物结合手术治疗本病有效。本文对其发生的病因、病理、发病机理、临床表现和现代诊疗方法进行了综述。     

急性视网膜坏死

急性视网膜坏死是由疱疹类病毒感染导致的一组综合征，主要包括急性葡萄膜炎，视网膜血管炎及视网膜坏死并脱离。目前已确诊其病原为水痘－带状疱疹病毒，以无环岛苷为主的药物结合手术治疗本病有效。本对其发生的病因、病理、发病机理、临床表现和现代诊疗方法进行了综述。     

急性视网膜坏死早期治疗

急性视网膜坏死 (acuteretinalnecrosis,ARN)是由疱疹病毒感染引起的 ,临床上早期以急性前葡萄膜炎、玻璃体炎、闭塞性视网膜血管炎、视网膜坏死为主要特征的眼部综合征。ARN发病率近年来有增多的趋势 ,随着无环鸟苷 (ACV)的应用、激光凝固术及玻璃体手术的进展 ,ARN的愈后有很     

眼球恶性淋巴瘤的诊断及治疗

眼球恶性淋巴瘤是淋巴瘤的一种特殊类型，原发或继发于葡萄膜、视网膜及玻璃体，迄今国内外仅有一百余例报告。该病在眼部的临床表现多种多样，主要果及葡萄膜，其次累及视网膜及玻璃体，与中枢神经系统淋巴瘤密切相关，易误诊为慢性葡萄膜炎、视网膜血管炎、急性视网膜坏死等多种眼部疾病而延误早期治疗时机。其原因与该病发病倒数少，认识不足有关，故将历年来国内外有关报告，对该病的临床表现、诊断及鉴别诊断、治疗及预后等几个方面进行综述。     

急性视网膜坏死综合征的临床特征及诊断

回顾分析急性视网膜坏死综合征(acute retinal necrosis syndrome,ARNS)临床及基础研究的文献资料,综述其临床发展规律及诊断方法.典型的ARNS临床过程分为4期,其分期对该病的治疗及视网膜脱离的预防具有重要的意义.根据典型临床表现可做出临床诊断,聚合酶链反应及抗体免疫测定可确定病因诊断.及时准确的诊断及早期治疗,才能保存有效的视力.     

急性视网膜坏死的研究现状

急性视网膜坏死是一种严重的致盲性眼病,以急性葡萄膜炎、玻璃体炎、闭塞性视网膜动脉炎、视网膜全层坏死为显著特征,晚期常并发视网膜脱离、增生性玻璃体视网膜病变.急性视网膜坏死病程进展迅速,预后较差,常导致患者视力严重下降,甚至视力丧失.目前临床上对急性视网膜坏死的诊断和治疗方面还存在不少问题,主要表现在误诊情况时有发生,治疗不及时或缺乏对因用药,而使患者失去最佳治疗时机.近年来,有研究者发现人疱疹病毒4型与急性视网膜坏死有相关性,也有研究者对其免疫遗传机制和用药方案进行了探讨.笔者就目前国内外对急性视网膜坏死的流行病学、病因、发病机制、临床表现特点、诊断、鉴别诊断及治疗的研究现状进行综述,以与同道交瀛.     

急性视网膜坏死综合征误诊分析5例

目的:急性视网膜坏死综合征是一种以中到重度葡萄膜炎、血管炎以及血管闭塞性视网膜坏死为特征的严重眼病,其早期诊断比较困难,有的甚至在行玻璃体视网膜手术过程中才被确诊。分析临床上急性视网膜坏死综合征误诊的原因,总结早期诊断的经验。方法:回顾我院5例未能及时诊断的急性视网膜坏死综合征病例的临床特点,诊治经过及最终预后,并分析误诊原因。结果:5例病例中,1例被误诊为虹膜睫状体炎,2例误诊为葡萄膜炎并视网膜脱离,1例误诊为视网膜中央动脉阻塞,1例被误诊为出血性视网膜血管炎。这些疾病在临床诊断过程中有必要考虑与急性视网膜坏死鉴别。结论:急性视网膜坏死综合征临床表现变异较大,有些表现不典型,临床工作中应充分认识此疾病。     

急性视网膜坏死的诊断与治疗

目的 探讨急性视网膜坏死早期诊断、药物治疗及手术治疗。方法 对急性视网膜坏死2例(3眼)的临床表现和治疗结果作回顾性分析。结果 此2例(3眼)早期均误诊，药物治疗和手术治疗疗效果不佳。结论 对类似葡萄膜炎者在早期要注意眼底周边部的改变，特别要注意和中间葡萄膜炎相鉴别。急性视网膜坏死患者药物治疗不能控制病情，手术治疗效果不佳，预后不良。     

Acute retinal necrosis results in low vision in a young patient with a history of herpes simplex virus encephalitis

Acute retinal necrosis (ARN), secondary to herpes simplex encephalitis, is a rare syndrome that can present in healthy individuals, as well as immuno‐compromised patients. Most cases are caused by a secondary infection from the herpes virus family, with varicella zoster virus being the leading cause of this syndrome. Potential symptoms include blurry vision, floaters, ocular pain and photophobia. Ocular findings may consist of severe uveitis, retinal vasculitis, retinal necrosis, papillitis and retinal detachment. Clinical manifestations of this disease may include increased intraocular pressure, optic disc oedema, optic neuropathy and sheathed retinal arterioles. A complete work up is essential to rule out cytomegalovirus retinitis, herpes simplex encephalitis, herpes virus, syphilis, posterior uveitis and other conditions. Depending on the severity of the disease, the treatment options consist of anticoagulation therapy, cycloplegia, intravenous acyclovir, systemic steroids, prophylactic laser photocoagulation and pars plana vitrectomy with silicon oil for retinal detachment. An extensive history and clinical examination is crucial in making the correct diagnosis. Also, it is very important to be aware of low vision needs and refer the patients, if expressing any sort of functional issues with completing daily living skills, especially reading. In this article, we report one case of unilateral ARN 20 years after herpetic encephalitis.     

Acute retinal necrosis associated optic neuropathy

Acute retinal necrosis (ARN) syndrome is characterized by severe intraocular inflammation, occlusive vasculopathy and peripheral retinal necrosis. Vision threatening complications of this syndrome include retinal detachment, macular oedema and ischaemia and optic neuropathy. Optic nerve involvement may be the presenting sign of ARN and this condition should be included in the differential diagnosis of acute papillitis. Several mechanisms may lead to ARN associated optic neuropathy including vasculitis, optic nerve ischaemia and direct optic nerve invasion by the herpes virus. We review optic nerve involvement during ARN and present its incidence, pathogenesis, differential diagnosis and treatment.     

Bilateral acute retinal necrosis syndrome associated with meningoencephalitis caused by herpes simplex virus 2. A case report

INTRODUCTION: Acute retinal necrosis syndrome (ARN syndrome) is a rare viral disease with a poor prognosis in most cases. It is characterized by substantial ocular inflammation with progressive retinal necrosis, occlusive vasculitis and sometimes extraocular features. CASE REPORT: We report the case of a 62-year-old woman who was referred for a suspicion of a stroke. Ophthalmological examination revealed a profound bilateral visual loss due to extensive retinal necrosis. The patient was immediately treated with antiherpetic drugs. ARN syndrome with meningoencephalitis caused by herpes simplex virus type 2 was confirmed by PCR studies performed on aqueous humor and cerebrospinal fluid. Herpes simplex virus 2 (IgG+ , IgM-) was probably reactivated after intrathecal injection of steroids because of pain associated with narrowing of the lumbar vertebral canal. The patient was treated with intravenous Acyclovir for 3 weeks. After 4 months, both retinas were detached. DISCUSSION AND CONCLUSION: ARN syndrome caused by herpes simplex virus 2 most often occurs after reactivation of the latent virus in patients with a neurological medical history or congenital infection. Antiviral treatment must begin early to decrease risks of bilateralization and complications.     

Overview and Diagnosis of Acute Retinal Necrosis Syndrome

Acute retinal necrosis (ARN) syndrome, also known as Kirisawa's uveitis, is one of the most serious ocular diseases, and is characterized by a combination of peripheral, confluent, necrotizing retinitis, retinal arteritis, and intraocular inflammation. ARN syndrome is caused by the herpesvirus family, including herpes simplex virus (HSV) and varicella-zoster virus (VZV). The diagnosis of ARN syndrome is fundamentally based on clinical appearance and the demonstration of viral infection. Recently, polymerase chain reaction techniques permit detection of very small amounts of viral DNA in intraocular specimens. This knowledge can help in both the diagnosis and design of therapeutic strategy for ARN syndrome. Here we review the clinical presentation and the current advances in the diagnosis of ARN syndrome.     

Overview and diagnosis of acute retinal necrosis syndrome

Acute retinal necrosis (ARN) syndrome, also known as Kirisawa's uveitis, is one of the most serious ocular diseases, and is characterized by a combination of peripheral, confluent, necrotizing retinitis, retinal arteritis, and intraocular inflammation. ARN syndrome is caused by the herpesvirus family, including herpes simplex virus (HSV) and varicella-zoster virus (VZV). The diagnosis of ARN syndrome is fundamentally based on clinical appearance and the demonstration of viral infection. Recently, polymerase chain reaction techniques permit detection of very small amounts of viral DNA in intraocular specimens. This knowledge can help in both the diagnosis and design of therapeutic strategy for ARN syndrome. Here we review the clinical presentation and the current advances in the diagnosis of ARN syndrome.     

Viral causes of the acute retinal necrosis syndrome

Acute retinal necrosis has been described as a clinical entity for nearly 30 years. Acute retinal necrosis is a potentially visually devastating necrotizing vaso-occlusive retinitis affecting both healthy and immunocompromised patients. Acute retinal necrosis is caused by the herpes group of viruses, mainly varicella zoster, herpes simplex types 1 and 2, and, rarely, cytomegalovirus. Recently, polymerase chain reaction techniques have enabled detection of very small amounts of viral DNA from intra-ocular fluid samples. This can help in both the diagnosis of atypical cases of retinitis and uveitis and directing treatment in cases of acute retinal necrosis.