上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (8): 1099-.doi: 10.3969/j.issn.1674-8115.2011.08.011

• 专题报道（眼科视觉科学） • 上一篇    下一篇

急性视网膜坏死综合征的误诊原因分析及治疗效果

闫 焱, 沈 玺, 张 琼, 李 娜   

  1. 上海交通大学 医学院附属瑞金医院眼科, 上海 200025
  • 出版日期:2011-08-28 发布日期:2011-08-29
  • 作者简介:闫 焱（1979—）, 男, 主治医师, 博士；电子信箱: hz2004yan@163.com。
  • 基金资助:

    上海市重点学科科研启动基金（S30205）；上海交通大学医学院科技基金（09XJ21071）

Analysis of causes of misdiagnosis and treatment effects of acute retinal necrosis syndrome

YAN Yan, SHEN Xi, ZHANG Qiong, LI Na   

  1. Department of Ophthalmology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Online:2011-08-28 Published:2011-08-29
  • Supported by:

    Shanghai Key Discipline Scientific Research Foundation, S30205；Shanghai Jiaotong University School of Medicine Foundation, 09XJ21071

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摘要：

目的 探讨急性视网膜坏死综合征（ARN）的误诊原因及治疗效果。方法 回顾性分析7例（7眼）ARN患者的误诊原因及治疗效果。结果 7例患者中3例误诊为虹膜睫状体炎，2例误诊为全葡萄膜炎，1例误诊为青光眼-睫状体炎综合征，1例误诊为视网膜出血。确诊后，7眼中4眼给予抗病毒药物及玻璃体手术治疗，3眼予抗病毒药物及眼底激光治疗。随访3~39个月，6例治疗后视力比治疗前有明显改善，治疗后最佳矫正视力从眼前指数至0.6不等。2例玻璃体手术患者取硅油后，均出现低眼压，视力下降。结论 ARN的早期诊断至关重要，如误诊会失去最佳治疗机会。早期、足量药物治疗联合眼内激光，必要时行玻璃体手术，可挽救ARN患者的残存视力。

关键词: 急性视网膜坏死, 误诊, 治疗

Abstract:

Objective To investigate the causes of misdiagnosis and treatment effects of acute retinal necrosis syndrome (ARN). Methods The causes of misdiagnosis and treatment effects of 7 patients (7 eyes) with ARN were retrospectively analysed. Results Three patients were misdiagnosed as iridocyclitis, 2 as panuveitis, 1 as Posner-Schlossman Syndrome and 1 as retinal hemorrhage. After the diagnosis was confirmed, antiviral medications and vitrectomy were administered to 4 patients, and antiviral medications and prophylactic laser were performed in the other 3 cases. During the follow up, visual acuity significantly improved in 6 patients. Ocular hypotony and decreased visual acuity took place in 2 patients after oil removal in vitrectomy. Conclusion The early diagnosis of ARN is of great significance, and best treatment opportunity may be missed due to misdiagnosis. As soon as the diagnosis is confirmed, the early management with sufficient medications and prophylactic laser, with vitrectomy if necessary, may preserve the residual visual acuity of patients with ARN.

Key words: acute retinal necrosis, misdiagnosis, treatment