急性视网膜坏死综合征15例临床研究

The Clinical Analysis of Acute Retinal Necrosis in 15 Cases

目的探讨急性视网膜坏死综合征(acute retinal necrosis syndrome,ARNS)的有效治疗方法。方法研究15例(16眼)ARNS患者的临床表现和治疗方法。术前视力光感0.1以下者10眼(62.50%),0.2者2眼(12.50%),0.3者1眼(6.25%),0.4者2眼(12.50%),0.5者1眼(6.25%)。结果 15例(16眼)ARNS术后视力均有不同程度提高,治疗3个月后视力0.01～0.1者5眼(31.25%);0.2者1眼(6.25%);0.3者4眼(25.00%);0.4者3眼(18.75%);0.5者1眼(6.25%);0.6者2眼(12.50%)。其中矫正视力0.2以上者5眼(31.25%);矫正视力0.1以上者6眼(37.5%);5眼(31.25%)视力无明显改变;最好视力达0.6。结论所有病人出院时病情都得到有效控制,对大部分病例而言,术前至少需2周抗病毒治疗;必要时行玻璃体切除手术,效果较好。

Objective To observe the treatment of acute retinal necrosis syndrome（ARNS）.Methods The treatment experiences of 16 eyes with ARNS in 15 patients during January 2008 to December 2010 were reviewed.The preoperative vision was 0.01~0.1 in 10 eyes（62.50%）,0.2 in 2 eyes（12.50%）,0.3 in 1 eye（6.25%）,0.4 in 2 eyes（12.50%）,0.5 in 1 eye（6.25%）.Results Postoperative vision was improved by different degree in 15 cases of 16 eyes diagnosed ARNS.The vision was 0.01~0.1 in 5 eyes（31.25%）,0.2 in 1 eye（6.25%）,0.3 in 4 eyes（25.00%）,0.4 in 3 eyes（18.75%）,0.5 in 1 eyes（6.25%）,0.6 in 2 eyes（12.50%）.The condition of all patients was effectively controlled when discharged from hospital.The vision was corrected more than 0.2 in 5 eyes（31.25%）,more than 0.1 in 6 eyes（37.50%）,and was not obviously improved in 5 eyes（31.25%）.The best vision was 0.6.Conclusion If necessary,vitrectomy is a useful treatment for ARNS in most cases and anti-virus medicine may be used at least 2 weeks before operation.