急性视网膜坏死综合征治疗的临床分析

Clinical ananlysis of the treatment of acute retinal necrosis syndrom with 15 cases

目的:探讨急性视网膜坏死综合征(ARN)的临床有效治疗方法。方法:对选取2005年～2010年收治的15例(18只眼)ARN患者,分析其诊断标准和治疗方法。结果:所有病例在明确诊断后及早应用抗病毒药物,同时根据眼部情况,出现视网膜小裂孔、玻璃体混浊相对较轻者行预防性视网膜激光光凝治疗;而玻璃体混浊严重,视网膜裂孔较大或合并视网膜脱离者行玻璃体切割手术。15例(18眼)ARN患者治疗后视力提高的15只眼(83.33%),治疗3个月后视力分别为:0.01者1只眼(5.56%),0.04～0.1者8只眼(44.44%),0.1～0.5者5只眼(27.78%),0.6～0.8者3只眼(16.67%),1只眼因病情反复,二次行玻璃体切割术,视力无明显提高。结论:所有病例病情均得到不同程度控制,ARN应早期诊断,在应用抗病毒药物的同时联合预防性视网膜激光光凝和玻璃体切割术能够有效控制病情,提高治疗效果抢救患者视功能。

Objective To observe the treatment of acute retinal necrosis syndrome（ARN）. Method The treatment case of 18 eyes with ARN in 15 patients during September 2005 to September 2010 were reviewed. Results All cases should have early after definite diagnosis application of antiviral drugs. At the same time according to the eye situation, we should have prophylactic retinal laser photocoaqulationwhen appearing small hiatus, relatively vitreous opacity. While when the eyes were with severe vitreous opacity and the larger retinal hole or combined with retinal detachment,we requird vitrectomy operation treatment. In 15 cases （18 eyes） of ARN patients, after treatment they were with visual acuity improved in 15 eyes （83.33%） ,3 months after the treatment of vision were：0.01 in 1 eye （5.56%） ,0. 04 ~ 0. 1 in 8 eyes （44. 44% ） ,0. 1 ~0. 5 in 5 eyes （27.78%） ,0. 6 ~0. 8 in 3 eyes （ 16. 67% ）. Due to repeated illness,one eye had the sec- ond treatment with vitrectomy, but the visual acuity was not improved obviously. Conclusion All cases had vations degrees of control. ARN should be diagnosed early,in the application of antiviral drug combined with prophylactic retinal laser photocoagulation and vitrectomy can effectively control the disease,improve the therapeutic effect and rescue the visual function of patients.