急性视网膜坏死综合征抗病毒治疗前应用糖皮质激素的临床观察

Clinical observation on systemic glucocorticoid before antiviral therapy for acute retinal necrosis syndrome

目的:观察急性视网膜坏死综合征(ARN)使用抗病毒治疗前全身应用糖皮质激素的视力效果及视网膜脱离发生率。方法:回顾性分析山西省眼科医院2007年6月至2018年10月住院ARN 35例(38只眼)的临床资料。其中A组(8只眼)在抗病毒治疗前应用糖皮质激素,B组(30只眼)未应用糖皮质激素。随访时间为7~94个月。结果:随访末期视力(BCVA)A组[2.00(1.0,2.6)]低于B组[0.65(0.38,1.70)],差异有统计学意义(Z=-2.555,P=0.011)。随访末期视网膜脱离发生率A组为62.5%(5/8),高于B组的10.0%(3/30),差异有统计学意义(P=0.005)。结论:急性视网膜坏死综合征抗病毒治疗前全身应用糖皮质激素导致视力更差,视网膜脱离发生率更高。

Objective To observe visual acuity and rate of retinal detachment in patients with acute retinal necrosis syndrome(ARN)who received systemic glucocorticoid before antiviral therapy.Methods The clinical data of 38 eyes of 35 patients with ARN from Jun.2007 to Oct.2018 in Shanxi Eye Hospital were analyzed retrospectively.All cases received routine treatments.Group A included 8 eyes which underwent systemic glucocorticoid before antiviral therapy.Group B included 30 eyes which did not receive systemic glucocorticoid before antiviral therapy.The follow-up periods ranged from 7 to 96 months.Results In group A,the BCVA at the end of follow-up was 2.00(1.0,2.6)which was poorer than the 0.65(0.38,1.70)of group B(Z=-2.555,P=0.011).The incidence of retinal detachment at the end of follow-up was 62.5%(5/8)in group A and 10.0%(3/30)in group B,respectively.The rate of retinal detachment at the end of follow-up in group A was higher than that of group B(P=0.005).Conclusion Systemic glucocorticoid before antiviral therapy for the treatment of ARN can result in poorer visual acuity and a higher incidence of retinal detachment.