大泡状视网膜脱离治疗方法及疗效分析

Treatment methods and effect analysis of bullous retinal detachment.

目的探讨大泡状视网膜脱离的治疗方法及效果。方法回顾性分析2005-2008年中山眼科中心经眼底和荧光素或/和吲哚青绿血管造影检查确诊为大泡状视网膜脱离或弥漫性视网膜色素上皮病变者17例,其中2例单纯进行药物治疗,8例氩激光封闭渗漏点,7例进行巩膜外放液或玻璃体切除术加膨胀气体或硅油填充或结合术前或术中术后眼底激光治疗,所有激光和/或手术治疗的病例,均联合药物治疗。随诊6个月以上。结果 17例中,2例单纯药物治疗及8例氩激光治疗者视力均有提高,手术治疗的7例中除2例因病情严重经手术及激光治疗视力下降外,5例均有改善或保持原有视力。结论各种治疗方法对大泡状视网膜脱离均有一定的疗效,其中视网膜光凝治疗效果最佳,早期治疗效果好,晚期手术治疗可以挽救一些患者的有用视力。

Objective To discuss the treatment methods and effection of bullous retinal detachment. Methods It was retrospective case series study. The clinical data of 17 patients with bullous retifial detachment （BRD） or diffuse retinal pigment epitheliopathy （ DRPE ）from 2005 to 2008 at the Zhongshan Ophthalmic Center, which had been diagnosed by ocular fundus examination, fundus fluorescein angiography （FFA） and/or indoeyanine green angiography （ICGA）. The follow-up period was more than 6 months. The exudative detachment of retina was caused by ocular inflammation or system diseases. The patients were 11 men and 6 women, with a mean age at initial visit of 42.8 years. Two patients were treated only by medicine; eight patients were treated by argon laser to block the leakages; seven cases were operated by scleral puncture tapping, vitreoretinal surgery and/or argon laser retinal photocoagulation. All these patients were managed with medicines at the same time. Results The visions had been improved in 2 cases of simple medicine treatment and 8 cases of simple argon laser retinal photocoagulation. Among 7 operated patients, 5 cases improved or keeps their vision well, and 2 cases were worse than before due to the bad retinal condition. Conclusion All the treatments are effective for bullous retinal detachment and the retinal photocoagulation is the most effective and direct method. The photocoagulation should be proceeded early. The patients in the advanced stage of bullous retinal detachment might save some vision by operation.