玻璃体切除术治疗急性视网膜坏死中皮质类固醇的应用效果  

The efficacy of corticosteroid in vitrectomy for the treatment of acute retinal necrosis

作　　者：刘海洋[1] 管莉娜[1] 李甦雁[1] 张正培[1] 

机构地区：[1]徐州市第一人民医院眼科 徐州市眼病防治研究所 徐州医科大学,江苏221000

出　　处：《中华眼外伤职业眼病杂志》2017年第11期815-818,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨急性视网膜坏死（ARN）早期玻璃体切除术治疗的基础上联合皮质类固醇治疗的效果。方法回顾性分析ARN22例（22只眼）的临床资料。随机分为皮质类固醇治疗组13例和非皮质类固醇治疗组9例，统计分析治疗前的最佳矫正视力（BCVA）、确诊至行玻璃体切除术的间隔时间、术中玻璃体填充物、出现视网膜脱离（RD）的眼数、低眼压的眼数、末次随访时BCVA及并发症等。结果患者入院一般资料两组间差异无统计学意义。皮质类固醇组与非皮质类固醇组患者相比，确诊至行玻璃体切除术间隔时间更长（P=0．042），硅油填充率较高（P=0．018），末次随访BCVA≥0．1的眼数较少（P=0．041）。结论ARN患者建议早期行玻璃体切除术治疗，但是皮质类固醇治疗需慎重。Objective To investigate the efficacy of corticosteroid combined with early vitrectomy in the treatment of acute retinal necrosis（ARN）. Methods Twenty-two eyes of 22 cases of ARN were analyzed retrospectively and they were randomly divided into 2 groups： the corticosteroid group, 13 cases, and the non-corticosteroid group ,9 cases. The best corrected visual acuity （BCVA） preoperative, time from diagnosis to vitrectomy, intravitreal tamponade, occurrence of retinal detachment （RD）, ocular hypotony, the BCVA at final follow-up and complications were analyzed. Results The difference of common data between the 2 groups were not statistically significant. The time from diagnosis to vitrectomy in the corticosteroid group was longer than that of non-corticosteroid group （ P = 0. 042 ）, rate of silicon oil tamponade in corticosteroid group was higher than that of non-corticosteroid group （ P = 0. 018 ）, and the eyes of BCVA ≥ 0. 1 in corticosteroid group were less than those of non-corticosteroid group （ P = 0.041 ）. Conclusion Prophylactic vitrectomy is recommended for the treatment of ARN, but the corticosteroid should be used with caution.

关 键 词：视网膜坏死 急性 治疗 玻璃体切除术 皮质类固醇 

分 类 号：R779.6[医药卫生—眼科]