经光学相干断层扫描的急性视网膜坏死九例患者临床分析  

Analysis on nine cases with acute retinal necrosis detected by optical coherence tomography

作　　者：董愉 柳月红 许雪静 刘彬彬 Dong Yu;Liu Yuehong;Xu Xuejing;Liu Binbin(Department of Eye,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院眼科

出　　处：《中华实验和临床感染病杂志（电子版）》2019年第6期512-514,共3页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：感染病科国家临床重点专科建设项目

摘　　要：目的探讨经光学相干断层扫描(OCT)的急性视网膜坏死(ARN)患者的眼底表现。方法对9例ARN患者均进行OCT检查、最佳矫正视力、裂隙灯眼前节检查、散瞳后间接检眼镜检查、彩色眼底照相、视野、角膜内皮检查、荧光眼底血管造影检查,观察OCT眼底变化。结果9例患者共11只眼眼底检查发现玻璃体混浊、中周部视网膜见面积不等的斑片状视网膜坏死融合区、视网膜血管闭塞呈白线状。ARN患者临床诊断依据典型眼底表现:黄白色视网膜坏死病灶、闭塞性视网膜血管病变、前房和玻璃体腔炎性细胞等。对确诊的ARN患者静脉注射阿昔洛韦行抗病毒治疗,出现视网膜脱离时采取玻璃体切割手术。结论OCT彩色眼底照片上观察到的特定病变与其OCT图像一致。通过OCT对ARN患者早期确诊,及时诊断、及时治疗,可显著改善ARN患者的视功能,提高疗效及其生活质量。Objective To investigate the fundus manifestation of patients with acute retinal necrosis(ARN)examined by optical coherence tomography(OCT).Methods OCT,best corrected visual acuity,slit lamp anterior segment examination,indirect ophthalmoscope after mydriasis,color fundus photography,visual field,corneal endothelial examination and fundus fluorescein angiography were performed for 9 patients with ARN.The fundus changes of OCT were analyzed.Results Total of 11 eyes fundus examination of 9 patients showed vitreous opacity,focal lamellar retinal necrosis of the fusion area,retinal vessel occlusion is white linear.The clinical diagnosis of ARN patients was based on typical fundus findings:yellow-white retinal necrosis,occlusive retinopathy,anterior chamber and vitreous inflammatory cells,etc.Patients with ARN were treated with acyclovir intravenously and vitrification in the event of retinal detachment.Conclusions The specific lesions observed on the OCT color fundus were consistent with the OCT images.Early and timely diagnosis and timely treatment of ARN patients by OCT could significantly improve their visual function and life quality.

关 键 词：急性视网膜坏死 光学相干断层扫描 眼底表现 

分 类 号：R774.1[医药卫生—眼科]