急性视网膜坏死综合征二例误诊分析  

Analysis of Clinical Misdiagnosis of 2 Patients with Acute Retinal Necrosis Syndrome

作　　者：李咏 张丁 林慧 白云冬 李茜 LI Yong;ZHANG Ding;LIN Hui;BAI Yundong;LI Qian(Department of Ophthalmology and Otorhinolaryngology,the 82nd Army Group Hospital,Baoding,Hebei 071000,China)

机构地区：[1]陆军第82集团军医院眼耳鼻喉科,河北保定071000

出　　处：《临床误诊误治》2024年第20期22-25,共4页Clinical Misdiagnosis & Mistherapy

摘　　要：目的 分析急性视网膜坏死综合征(ARNS)的临床特点及容易引起误诊的原因,并总结防范误诊措施,以提高早期诊断正确率。方法 回顾分析2021年3月至2023年9月收治的一度误诊为青光眼、眼内炎的ARNS 2例病例资料。结果 1例以右眼视物不清3月余就诊,1例因左眼红、眼痛4 d急性发病入院。就诊初期一度误诊为青光眼、眼内炎,予相应治疗效果不佳,后经手术及眼底检查、光学相干断层成像检查,明确诊断为ARNS。误诊时间4 d至2个半月。确诊后经抗病毒药物、糖皮质激素等治疗出院,预后尚可。结论 ARNS病情进展较迅速且预后较差,是严重的致盲性眼病,而早期临床表现缺乏特异性,易误诊;加强对ARNS的认识,提高警惕性,仔细鉴别诊断,及时行相关医技检查,全面分析病情,避免早期误诊。Objective To analyze the clinical characteristics of acute retinal necrosis syndrome(ARNS)and the causes of misdiagnosis,and to summarize the preventive measures,so as to improve the accuracy of early diagnosis.Methods The data of 2 patients with ARNS misdiagnosed as glaucoma and endophthalmitis from March 2021 to September 2023 were retrospectively analyzed.Results One patient presented with blurred vision in the right eye for more than 3 months,and 1 patient was admitted to hospital with acute onset of red left eye and eye pain for 4 d.At initial hospital visit,it was misdiagnosed as glaucoma and endophthalmitis,and the corresponding treatment was not effective.After surgery,fundus examination and optical coherence tomography,the diagnosis was confirmed as ARNS.The duration of misdiagnosis was 4 d to 10 weeks.After diagnosis,he received treatment with antiviral drugs and glucocorticoids,and was discharged from hospital,with favorable prognosis.Conclusion ARNS is a serious blinding eye disease with rapid progression and poor prognosis,and early clinical manifestations lack specificity,which is prone to misdiagnosis.It is necessary to strengthen the understanding of ARNS,enhance vigilance,and perform careful differential diagnosis,timely relevant medical examination and comprehensive analysis of the condition,to avoid early misdiagnosis.

关 键 词：视网膜坏死 急性 误诊 青光眼 眼内炎 鉴别诊断 眼底检查 光学相干断层成像检查 

分 类 号：R774.1[医药卫生—眼科]