慢性顽固性Behcet 病手术治疗的初步观察

目的 观察玻璃体切割手术治疗慢性顽固性Behcet病的疗效。 方法 回顾分析8例Behcet病患者10只患眼常规玻璃体切割手术治疗后随访观察半年至3年的临床资料，分析手术前后视力、手术后炎症控制以及复发情况。全部患者为双眼发病，5例为完全型、3例为不完全型Behcet病。 结果 手术中发现患眼均有明显的玻璃体混浊、液化，普遍的视网膜颜色灰暗和视网膜血管变细，部分血管闭塞或伴有不同程度的血管鞘样改变。手术后所有接受治疗眼均有不同程度的视力提高，手术后第1、2周，1、6个月的视力与手术前相比其差异有统计学意义。随访观察期中，1个月内有3只眼出现过炎症复发；6个月内有6只眼出现过炎症复发；4只眼手术后炎症一直未再发。全部患眼均未出现因手术而诱发的急性炎症复发。 结论 玻璃体切割手术治疗慢性顽固性Behcet病可以提高患眼视力，手术安全有效。 (中华眼底病杂志, 2005, 21: 357-359)

Clinical analysis of incomplete Behçet's disease

Objective To investigate the clinical diagnosis and treatment of incomplete Behcet′s disease. Methods The clinical data of 52 patients (83 eyes) with incomplete Behcet′s disease were retrospectively analysed. Visual acuity and results of examination of slit-lamp microscope, ocular fundus, and fundus fluorescein angiography (FFA) were observed and analysed. All of patients were treated by local cycloplegic, systemic treatment with glucocorticoid and cytoxan. The followed-up period was 1 year or more. Results Recurrent hypopyon or empyema of anterior chamber angle, and hyperaemia of optic papilla was found in 54 and 41 eyes, respectively. The results of FFA showed that abnormal changes were found in all of the eyes. There was vascular leakage and staining of optic papilla at the early and late stage in 83 eyes (100%), diffuse leakage of retinal capillary vessel in 83 eyes (100%), and leakage of affected branch of retinal vessel and staining of the vascular wall at the late stage in 71 eyes (85.54%).After the treatment, the disease recovered completely in 20 patients (26 eyes), recovered partly in 20 (33 eyes), and alleviated in 12 (24 eyes). No patients suffered from hypopyon or empyema of anterior chamber angle and hyperemia of optic papilla. None of the patients had oral ulcer, genital ulcer or arthritis until the last day of the follow-up. Conclusions Recurrent hypopyon, papillitis, and retinal vasculitis were the main clinical manifestations of incomplete Behcet′s disease. FFA redounds to the diagnosis of the disease and timely application of cycloplegic and systemic application of glucocorticoid and cytoxan may inhibit the aggravation of the disease effectively. (Chin J Ocul Fundus Dis, 2005, 21: 353-356)