Vogt-小柳-原田综合征急性期黄斑部病变对视力预后的影响

Impact of macular lesions in acute stage of Vogt-Koyanagi-Harada syndrome on visual prognosis

目的 探讨Vogt-小柳-原田综合征（VKHs）患者急性期黄斑区视网膜神经纤维层脱离、水肿对视力预后的影响.方法 回顾性分析2006年12月至2009年1月在中山大学中山眼科中心就诊的VKHs初发患者74例（108眼）的黄斑部病变情况及治疗前、后患者的视力分布,比较有和无黄斑部脱离、水肿的患者治疗后的视力.结果 74例VKHs患者中,有黄斑部脱离、水肿的患者53例（71.62％）,无黄斑部脱离、水肿的患者21例（28.38％）.有黄斑部脱离、水肿者,发病时视力下降主要集中在0.01～＜0.5的视力段范围;而无黄斑部脱离、水肿者,发病时视力下降主要集中在0.1～＜0.5的视力段范围.急性期有和无黄斑部脱离、水肿的患者治疗后视力≥1.0的比例分别为86.79％ （46/53）和100％（21/21）,差异无统计学意义（P＞0.05）.结论 VKHs患者急性期无论是否出现黄斑部病变,进行及时有效地治疗后不影响视力预后.

Objective To investigate the impact of the detachment and edema of acute macular retinal nerve fiber layer on visual prognosis in patients with Vogt-Koyanagi-Harada syndrome（VKHs）.Methods A retrospective analysis was performed on the macular lesions,visual distribution before and after treatment of 74 VKHs of the first attack patients （108 eyes） whom visited Zhongshan Ophthalmic Center,Sun Yat-sen University from December 2006 to January 2009.The post-treatment vision of the patients with or without macular detachment and edema were compared.Results There were 53 patients with macular detachment and edema （71.62％）,and 21 patients without （28.38％） in 74 VKHs patients.The incipient hypopsia of the VKHs patients with macular detachment and edema was mainly distributed over 0.01 to ＜0.5,and 0.1 to ＜0.5 in patients without macular detachment and edema.The proportions of visual acuity ≥1.0 after treatment were 86.79％ （46/53） and 100％ （21/21） in VKHs patients of acute phase with or without macula detachment and edema （P＞0.05）.Conclusion With timely and effectively treatment,the visual prognosis is not affected by the acute macular lesions in VKHs patients.