急性視網(wǎng)膜壞死綜合征晚期病例的臨床分析
發(fā)布時(shí)間：2018-09-07 18:37
【摘要】： 目的 急性視網(wǎng)膜壞死綜合征是臨床上相對(duì)少見(jiàn)的眼科疾病,其晚期病例因視網(wǎng)膜脫離而預(yù)后較差。本文擬通過(guò)近年在我院住院的急性視網(wǎng)膜壞死綜合征晚期病例,對(duì)其臨床表現(xiàn)、診斷及治療做一個(gè)總結(jié)和分析,從而為該病的診斷和治療提供依據(jù),減少誤診率,實(shí)現(xiàn)該病的早期診斷和早期治療。 方法 回顧性調(diào)查及分析2008年1月至2010年3月期間在我院眼科中心住院病人中診斷急性視網(wǎng)膜壞死綜合征繼發(fā)視網(wǎng)膜脫離的病例,并對(duì)其病程、曾作出的診斷、先前曾給予的治療方案、和住院手術(shù)療效等方面進(jìn)行分析,總結(jié)急性視網(wǎng)膜壞死綜合征這一疾病的診斷和治療。 結(jié)果 近兩年中因急性視網(wǎng)膜壞死綜合征晚期繼發(fā)視網(wǎng)膜脫離的病例共9例(10只眼),入院擬行手術(shù)治療。男性8例9只眼(1例雙眼發(fā)病),女性1例1只眼,年齡27～63歲,平均年齡50.4±12.5歲。術(shù)前視力0.02的1只眼,手動(dòng)／20cm～手動(dòng)／眼前5只眼,4眼為光感。7例8只眼在診斷急性視網(wǎng)膜壞死綜合征之前曾被誤診,分別在他院誤診為結(jié)膜炎、青睫綜合癥,葡萄膜炎和玻璃體混濁等,2例2只眼為發(fā)病初期即在我院診治的病人；3例3只眼在本次住院前未作抗病毒治療；發(fā)病后7～120天發(fā)生視網(wǎng)膜脫離,平均50.9±39.5天。 本組9例10只眼均在局麻下接受玻璃體切除硅油填充視網(wǎng)膜復(fù)位手術(shù),其中7例8只眼聯(lián)合眼內(nèi)光凝,3例聯(lián)合晶狀體超聲乳化+人工晶狀體植入術(shù),手術(shù)后均達(dá)視網(wǎng)膜脫離解剖復(fù)位,術(shù)后視力光感～0.15。1例1只眼術(shù)后8個(gè)月取油,矯正視力達(dá)0.1,視網(wǎng)膜平伏。1例1只眼術(shù)后5個(gè)月取油,矯正視力達(dá)0.15,視網(wǎng)膜平伏。 結(jié)論 急性視網(wǎng)膜壞死綜合征是臨床上較少見(jiàn)的一種疾病,目前該病的診斷標(biāo)準(zhǔn)明確,但是誤診率仍然較高,初診時(shí)若不散瞳仔細(xì)檢查眼底,易誤診為葡萄膜炎、青睫綜合征等,從而延誤治療。該病晚期的視網(wǎng)膜脫離發(fā)生率高,玻璃體切除硅油填充手術(shù)可有效達(dá)到視網(wǎng)膜解剖復(fù)位,術(shù)后視力可有一定程度的提高。
[Abstract]:objective
Acute retinal necrosis syndrome (ARNS) is a relatively rare clinical ophthalmic disease with poor prognosis due to retinal detachment. This paper summarizes and analyzes the clinical manifestations, diagnosis and treatment of ARNS hospitalized in our hospital in recent years, so as to provide a basis for the diagnosis and treatment of the disease. Reduce misdiagnosis rate and achieve early diagnosis and early treatment.
Method
A retrospective investigation and analysis of the cases of acute retinal necrosis syndrome with secondary retinal detachment diagnosed in our Ophthalmic Center from January 2008 to March 2010 was made. The course of the disease, the diagnosis made, the treatment schemes given previously, and the effect of hospitalized surgery were analyzed. The comprehensive treatment of acute retinal necrosis was summarized. Diagnosis and treatment of this disease.
Result
In the past two years, 9 cases (10 eyes) with advanced retinal detachment due to acute retinal necrosis syndrome (ARNS) were hospitalized for surgical treatment. There were 8 males (9 eyes) and 1 females (1 eye), aged 27-63 years, with an average age of 50.4 (+ 12.5 years). Sense. 7 cases 8 eyes were misdiagnosed before the diagnosis of acute retinal necrosis syndrome, misdiagnosed as conjunctivitis, cyanociliary syndrome, uveitis and vitreous opacity in his hospital respectively, 2 cases 2 eyes were diagnosed and treated in our hospital at the initial stage of the disease; 3 cases 3 eyes did not receive antiviral treatment before hospitalization; 7-120 days after the onset of the disease occurred retina. The average membrane separation was 50.9 + 39.5 days.
Nine cases (10 eyes) underwent vitrectomy and silicone oil-filled retinal reattachment under local anesthesia. Among them, 7 cases (8 eyes) underwent intraocular photocoagulation, 3 cases (3 eyes) underwent phacoemulsification and intraocular lens implantation. All cases achieved anatomical reattachment of retinal detachment. The postoperative visual acuity of 1 eye was 0.15. In the 1 eyes of the retina, 5 eyes were taken for oil, the corrected visual acuity was 0.15, and the retina was.1.
conclusion
Acute retinal necrosis syndrome (ARNS) is a rare disease in clinic. At present, the diagnostic criteria of ARNS are clear, but the misdiagnosis rate is still high. If the fundus of the eye is not dilated carefully, it is easy to be misdiagnosed as uveitis and cyanociliary syndrome, and so on. The incidence of late retinal detachment is high. Vitrectomy with silicone oil tamponade. Surgery can effectively achieve the anatomical reduction of the retina, and the postoperative visual acuity can be improved to a certain extent.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類(lèi)號(hào)】：R774
本文編號(hào)：2229095
[Abstract]:objective
Acute retinal necrosis syndrome (ARNS) is a relatively rare clinical ophthalmic disease with poor prognosis due to retinal detachment. This paper summarizes and analyzes the clinical manifestations, diagnosis and treatment of ARNS hospitalized in our hospital in recent years, so as to provide a basis for the diagnosis and treatment of the disease. Reduce misdiagnosis rate and achieve early diagnosis and early treatment.
Method
A retrospective investigation and analysis of the cases of acute retinal necrosis syndrome with secondary retinal detachment diagnosed in our Ophthalmic Center from January 2008 to March 2010 was made. The course of the disease, the diagnosis made, the treatment schemes given previously, and the effect of hospitalized surgery were analyzed. The comprehensive treatment of acute retinal necrosis was summarized. Diagnosis and treatment of this disease.
Result
In the past two years, 9 cases (10 eyes) with advanced retinal detachment due to acute retinal necrosis syndrome (ARNS) were hospitalized for surgical treatment. There were 8 males (9 eyes) and 1 females (1 eye), aged 27-63 years, with an average age of 50.4 (+ 12.5 years). Sense. 7 cases 8 eyes were misdiagnosed before the diagnosis of acute retinal necrosis syndrome, misdiagnosed as conjunctivitis, cyanociliary syndrome, uveitis and vitreous opacity in his hospital respectively, 2 cases 2 eyes were diagnosed and treated in our hospital at the initial stage of the disease; 3 cases 3 eyes did not receive antiviral treatment before hospitalization; 7-120 days after the onset of the disease occurred retina. The average membrane separation was 50.9 + 39.5 days.
Nine cases (10 eyes) underwent vitrectomy and silicone oil-filled retinal reattachment under local anesthesia. Among them, 7 cases (8 eyes) underwent intraocular photocoagulation, 3 cases (3 eyes) underwent phacoemulsification and intraocular lens implantation. All cases achieved anatomical reattachment of retinal detachment. The postoperative visual acuity of 1 eye was 0.15. In the 1 eyes of the retina, 5 eyes were taken for oil, the corrected visual acuity was 0.15, and the retina was.1.
conclusion
Acute retinal necrosis syndrome (ARNS) is a rare disease in clinic. At present, the diagnostic criteria of ARNS are clear, but the misdiagnosis rate is still high. If the fundus of the eye is not dilated carefully, it is easy to be misdiagnosed as uveitis and cyanociliary syndrome, and so on. The incidence of late retinal detachment is high. Vitrectomy with silicone oil tamponade. Surgery can effectively achieve the anatomical reduction of the retina, and the postoperative visual acuity can be improved to a certain extent.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類(lèi)號(hào)】：R774
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相關(guān)期刊論文 前3條
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