IRVAN综合征的临床特征和治疗分析

Clinical feature and treatment analysis of IRVAN syndrome

目的观察IRVAN综合征的临床特征，探讨其治疗时机的选择。方法回顾分析5例（10只眼）确诊为IRVAN综合征的患者的资料，并根据其临床特征分为五期。对6只眼采用视网膜激光光凝治疗，4只眼联合应用玻璃体切割术与视网膜激光光凝术治疗，以观察疗效。结果5例患者10只眼中均有特发性视网膜动脉炎、后极部多发动脉瘤、视神经视网膜炎，周边部有视网膜血管闭锁及大面积毛细血管无灌注区。4只眼出现玻璃体积血，2只眼有视盘新生血管，1只眼黄斑区出现毛细血管无灌注区。其中4只眼处于Ⅱ期，6只眼均处于Ⅲ期。经过治疗后，目前视力≥0．6者4只眼，0．1～0．6者1只眼，≤0．1者5只眼。结论5例10只眼均具有IRVAN综合征的特点，符合其诊断标准。在Ⅱ期即周边部视网膜无灌注区形成新生血管之前或初期进行激光光凝治疗能稳定眼底病变的进展。

Objective To observe the clinical characteristics ot mlopatmc renna, vascunns aneurvsms, and neuroretinitis （IRVAN） syndrome, and to explore the optimum treatment timing. Methods The clinical data of 5 patients with IRVAN syndrome which were diagnosed by systemic exami- nation, anterior segment, fundus photography and fundus fluorescein angiography （FFA） were retrospectively analyzed. According to the clinical characteristics,the course was divided into five stages. Six eyes were treated with panretianl laser photocoagulation, 4 eyes treated with vitrectomy and panretihal laser photocoagulation. Results Idiopathic retinal vasculitis,multiple posterior retinal arterial aneu- rysms, neuroretinitis,retinal vascular occlusion and capillary nonperfusion were seen in all of the 10 eyes. Among them, 4 eyes had vitreous haemorrhage, 2 eyes had neovascularization in disk, 1 eye had non-perfusion area in the macular, 4 eyes had reached stage U, and 6 eyes had reached stage Ⅲ. After treatment,4 eyes had maintained ≥0.6 vision,l eye had 0.1-0.6 vision,and 5 eyes had ≤ 0.1 vision at the time of last follow-up. Conclusions Initiating panretinal laser photocoagulation at stage Ⅱ , which before （or shortly after） the development of any neovascularization might reduce the likelihood of disease progression.