急性视网膜坏死综合征临床治疗42眼

Acute retinal necrosis syndrome in 42 eyes

目的探讨急性视网膜坏死综合征(ARNS)的治疗方法并评价其治疗效果。方法对急性视网膜坏死综合征42眼进行药物、激光及手术综合治疗。所有患者均给予无环鸟苷及糖皮质激素治疗,对于药物治疗病情无好转或就诊时已有严重玻璃体混浊或已并发视网膜脱离患者,及时行玻璃体视网膜联合手术。随访6～24个月,分析其治疗效果。结果42眼炎症均得到有效控制,单眼发病患者对侧眼未出现发病。37眼视力有不同程度改善,其中23眼视力≥0.1,最好视力为0.8。40眼视网膜完全复位,部分复位1眼。结论急性视网膜坏死综合征是一种严重致盲性眼病,早期易被误诊,视网膜脱离是其常见的严重并发症。早期足量的抗病毒、皮质类固醇激素的应用以及玻璃体视网膜联合手术是治疗急性视网膜坏死综合征的有效方法。

Objective To explore the therapeutic methods for acute retinal necrosis syndrome and to evaluate the therapeutic effects of anti-virus drugs,photocoagulation and vitreous-retinal surgery.Methods Thirty-six cases（42 eyes） of acute retinal necrosis syndromes were studied.All were treated with acyclovir（ACV） and corticoid hormones.Those with severe vitreous inflammation or retinal detachment were treated with drugs,and photocoagulation in combination with surgery.Followed up from 6 to 24 months,the retinas and eyesight were observed.Results The retinas of 40 eyes were all successfully reattached,and the visual acuity of 37 eyes was improved,in which the acuity of 23 eyes was better than 0.1 and the best acuity was 0.8.Conclusion Retinal detachment is the most severe complication of acute retinal necrosis syndrome,and it can lead to visual loss and often is easily misdiagnosed.If it is diagnosed early and treated in time with proper methods such as effective drugs including acyclovir and corticoid hormones,photocoagulation and vitreous-retinal surgery,good results can be produced.