急性视网膜坏死综合症的临床治疗

Clinical treatment of acute retinal necrosis syndrome

目的探讨急性视网膜坏死综合征(acuteretinalnecrosissyndrome,ARNS)的病因、临床表现和临床治疗方法。方法对2002年12月到2004年9月期间在本院收治的9例ARNS患者13眼均分别给予抗病毒药物治疗、眼底激光治疗及玻璃体视网膜手术治疗,术后1m～17m随访患者视力及视网膜复位情况。结果9例13眼ARNS患者除1例双眼患者本人放弃治疗外,术后视力均有不同程度提高,其余11眼中手动/10cm者2眼,数指/20cm～100cm者5眼,0.05者1眼,0.25者1眼,0.4者2眼,大多维持了有用视力;予以玻璃体视网膜手术联合眼底激光治疗的5例7眼及单纯予以眼底激光的3例4眼,均保持了视网膜平伏。结论ARNS是一种严重的致盲性眼病,但如能早期发现、正确诊断并给予正确有效的联合治疗,是能够使大部分患者得到治愈或好转,挽救有用视力的。

Objective To discuss the pathogeny, clinical acquit and treatment of acute retinal necrosis syndrome （ARNS）. Methods 9 cases patients with 13 eyes diagnosed ARNS who were in our hospital and treated from December in 2002 to September in 2004 were operated by anti-virus medication, eyeground laser and vitreous-retinal surgery. Postoperative follow-up of the vision and the retinal replacement was 1 m-17m. Results Postoperative vision all improved by different degree in 9 cases patients with 13 eyes diagnosed ARNS except 1 case with boty eyes. 2 eyes＇vision was HM/10cm, 5 eyes＇vision was CF/20-100cm, 1 eyes＇vision was 0.05, 1 eyes＇vision was 0.25 and 2 eyes＇vision was 0.4 in the other 11 eyes. Mostly the useful vision was maintained. The retina of 5 cases with 7 eyes operated the vitreous-retinal surgery combined eyeground laser treatment and 3 cases with 4 eyes only operated the eyeground laser treatment all keeped flat. Conclusions ARNS is a serious syndrome leading to blindness. Most of the patient can be cured or turn for the better and the useful vision can be saved if ARNS can be finded carly and diagnosed accurately moreover be operated the accurate effective associated treatment.