急性视网膜坏死综合征的临床观察

目的:探讨急性视网膜坏死综合征(acute retinal necrosis ARN)临床诊断、治疗的有效方法.方法:回顾性分析我院2003-09/2006-07以来8例11眼ARN患者的临床表现、检查、诊治及预后.结果:8例患者中除1例1眼无眼前段表现外,其余7例(10眼)都表现为不同程度的眼前段炎症、玻璃体炎、坏死性视网膜炎和闭塞性视网膜血管炎.8例中1例(1眼)HSV-1阳性.治疗后视力提高共5眼(46%),最终视力≤0.1者7眼(64%).随访期内10眼(91%)病变控制.结论:ARN的诊断以临床表现为主.早期足量地抗病毒并联合应用糖皮质激素、预防性视网膜光凝、必要时玻璃体手术是控制病变的关键.

Clinical observation of acute retinal necrosis in 8 cases

AIM:To investigate the effective diagnosis and treatment of acute retinal necrosis(ARN). METHODS:Data were retrospectively analyzed on manifestation,examination,diagnosis,treatment and prognosis of 8 cases(11 eyes) with ARN in our hospital from September,2003 to July,2006. RESULTS:Except for 1 case(1 eye) positive to HSV-1,all the other 7 cases(10 eyes) had inflammation in anterior segment,vitritis,necrotizing retinitis and retinal vasculitis. After treatment,visual acuity was improved in 5 eyes(46%). Final visual acuity was lower than 0.1 in 7 eyes(64%). Signs were controlled in 10 eyes(91%) during the follow-up. CONCLUSION:The diagnosis of ARN should be mainly based on clinical manifestation. Early and sufficient treatment with antiviral agents,corticosteroid and prophylactic laser photocoagulation,sometimes vitrectomy are the key point to control the disease.