急性视网膜坏死综合征误诊分析5例  

Misdiagnosis of Acute retinal necrosis syndrome:5 cases

作　　者：冯朝晖[1] 周爱意[1] 权彦龙[1] 熊全臣[1] 

机构地区：[1]西安交通大学医学院第二附属医院眼科,中国陕西省西安市710004

出　　处：《国际眼科杂志》2009年第4期802-804,共3页International Eye Science

摘　　要：目的:急性视网膜坏死综合征是一种以中到重度葡萄膜炎、血管炎以及血管闭塞性视网膜坏死为特征的严重眼病,其早期诊断比较困难,有的甚至在行玻璃体视网膜手术过程中才被确诊。分析临床上急性视网膜坏死综合征误诊的原因,总结早期诊断的经验。方法:回顾我院5例未能及时诊断的急性视网膜坏死综合征病例的临床特点,诊治经过及最终预后,并分析误诊原因。结果:5例病例中,1例被误诊为虹膜睫状体炎,2例误诊为葡萄膜炎并视网膜脱离,1例误诊为视网膜中央动脉阻塞,1例被误诊为出血性视网膜血管炎。这些疾病在临床诊断过程中有必要考虑与急性视网膜坏死鉴别。结论:急性视网膜坏死综合征临床表现变异较大,有些表现不典型,临床工作中应充分认识此疾病。AIM： Acute retinal necrosis syndrome （ARNS） is a severe ocular syndrome consisting of a moderate-to- severe anterior uveitis, vasculitis, and vaso-occlusive retinal necrosis. There are a few difficulties on early diagnosis. Some cases were recognized until vitro-retinal surgery. The purpose of this research was to analysis the causes leading to misdiagnosis of acute retinal necrosis syndrome （ARNS） and summarize the experiences for early diagnosis. METHEDS： The manifestation, examination, diagnosis, treatment and complications, and final visual outcome of 5 patients with ARNS ever presented at our department were described and investigated retrospectively. RESULTS： One of the five cases was misdiagnosed as acute iridocyclitis until retinal necrosis was found; two cases of uveitis complicating with retinal detachment were diagnosed as ARNS during vitro-retinal surgery; one was misdiagnosis as central retinal artery occlusion. Another one ever was consider as hemorrhagic retinal vasculitis initially. These diseases need to be considered in the differential diagnosis. CONCLUSION： The clinical manifestations and clinical courses of ARNS have varied and atypical, fully understand is needed to us.

关 键 词：急性视网膜坏死综合征 视网膜血管炎 视网膜脱离 误诊 视网膜中央动脉阻塞 

分 类 号：R774.1[医药卫生—眼科]