|本期目录/Table of Contents|

[1]单玫,王冰,卢岚,等.观察阿昔洛韦干预急性视网膜坏死的不同时机对预后的影响[J].福建医科大学学报,2017,51(05):334-338.
 SHAN Mei,WANG Bing,LU Lan,et al.Comparison of the Effects of Acyclovir Administration Time on the Prognosis of Acute Retinal Necrosis Syndrome[J].Journal of Fujian Medical University,2017,51(05):334-338.
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《福建医科大学学报》[ISSN:1672-4194/CN:35-1192/R]

卷:
第51卷
期数:
2017年05期
页码:
334-338
栏目:
临床研究
出版日期:
2017-10-30

文章信息/Info

Title:
Comparison of the Effects of Acyclovir Administration Time on the Prognosis of Acute Retinal Necrosis Syndrome
文章编号:
16724194(2017)05033405
作者:
单玫1 王冰2 卢岚2 陈平2
作者单位: 1.北京怡德医院 眼科,北京100097; 2.福建医科大学 附属协和医院眼科,福州350001 作者简介: 单玫,女,主治医师,医学硕士
Author(s):
SHAN Mei1 WANG Bing2 LU Lan2 CHEN Ping2
1.Department of Ophthalmology, Beijing Eden Hospital, Beijing 100097, China; 2.Department of Ophthalmology, Fujian Medical University Union Hospital, Fuzhou 350001, China
关键词:
视网膜坏死综合征急性 视网膜脱离 玻璃体切除术 阿昔洛韦 预后
Keywords:
KEY WORDS:retinal necrosis syndrome acute retinal detachment vitrectomy Acyclovir prognosis
分类号:
R322.91; R774.1; R977; R978.7
DOI:
-
文献标志码:
A
摘要:
目的比较阿昔洛韦不同用药时机对急性视网膜坏死(ARN)远期视力及并发症的影响。方法回顾性分析18例18只眼出现视网膜脱离的ARN患者的临床资料。根据开始使用阿昔洛韦治疗的不同时间点,将患者分为A组(未早期治疗组,10只眼,发病2~6周开始使用阿昔洛韦)和B组(早期治疗组,8只眼,发病2周内开始使用阿昔洛韦)。18只眼最终均接受玻璃体切除+硅油填充术。比较2组患者手术前后的视力、术中视网膜坏死程度以及术后高眼压、复发性视网膜脱离和视神经萎缩等并发症的发生情况。 结果术前视力B组明显优于A组(P=0.004)。术中观察A组10只眼视网膜水肿、漏斗状脱离,蜘蛛网样坏死波及近全周视网膜,甚至赤道部后方;B组8只眼视网膜脱离较局限,坏死灶多位于视网膜周边。术后2月,A组视网膜中央血管闭塞、视乳头色苍白;B组视网膜中周部小血管闭塞,视乳头色淡红。术后复发性视网膜脱离A组(30%,3/10)高于B组(0,0/8)(P=0.216)。2组眼压无显著性差异(P>0.05)。术后1年,2组患者视力均有提高,B组明显优于A组(P<0.01),且B组的视力提高值也明显高于A组(P<0.05)。结论ARN早期(2周内)全身使用阿昔洛韦等抗病毒药物可明显改善患者远期视力,对减轻闭塞性视网膜中央血管病变和视神经萎缩也发挥关键作用。
Abstract:
ABSTRACT:ObjectiveTo compare the clinical outcomes of acute retinal necrosis (ARN) with different administration time of Acyclovir.MethodsEighteen patients (eighteen eyes) with retinal detachment (RD) secondary to ARN were included in this retrospective analysis.Patients were divided into two groups according to the Acyclovir administration time.Group A, with ten patients, were treated with Acyclovir between two to six weeks after disease onset.Group B with eight patients, were treated with Acyclovir within two weeks.All patients further underwent vitrectomy and silicone oil tamponade for retinal detachment.Patients were followed up for one year.Pre| and post| operative visual acuity(VA), extent of retinal necrosis, level of IOP, rate of recurrent RD, and level of optic nerve atrophy were investigated in two groups.ResultsThe preoperative VA in group B were better than that in group A(P=0.004).During surgery, the edematous, spider|web like retina and funnel|shaped RD were observed in all cases in group A.The necrosis lesion might extended to posterior portion of retina.While patients in group B presented with localized RD, mild retinal necrosis and peripheral vascular occlusion.Two months after surgery, occlusive central retinal vasculopathy and optic nerve atrophy were observed in group A, which were absent in group B.The rate of recurrent RD in group A(30%, 3/10) was higher than that in group B(0%, 0/8)(P=0.216).There was no significant difference in IOP between the two groups.One year after surgery, VA improved in both groups and more significantly in group B (P<0.01).Similar finding was found in visual recovery value(P<0.05).ConclusionEarlier systemic Acyclovir administration may result in better clinical outcome compared to late Acyclovir administration in patients with acute retinal necrosis.

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备注/Memo

备注/Memo:
通讯作者: 陈平. Email: xhchenp@163.com
更新日期/Last Update: 2017-10-30