CAJ | 학술논문

目的观察研究一少数民族淀粉样玻璃体变性家系患者的临床特点及玻璃体切割手术联合视网膜氪激光光凝的疗效.方法对2008～2012年在江苏省中医院主诊的3例来自同一少数民族家系的患者6只眼行玻璃体切割手术联合视网膜氪激光光凝治疗.于术前及术后1～2年进行详细的眼部检查,包括视力、裂隙灯、眼底镜、光学相干断层扫描、荧光素钠眼底血管造影、眼部B超及角膜共焦显微镜.结果 6只眼于术前均有视力严重下降、玻璃体腔内絮状混浊物、晶状体后方“足盘样混浊”的典型表现.5只眼的最佳矫正视力于术后达到1.0,但术后2年6只眼均发现存在新的周边视网膜病灶.其中1只眼出现玻璃体混浊复发伴随高眼压症状,共聚焦显微在其角膜内皮后方发现高反光颗粒状物质沉积.结论国内玻璃体淀粉样变性患者的临床表现与国外报道存在一定区别,玻璃体切割手术能有效地治疗该病,但术后视网膜病变及玻璃体混浊可能会复发,并可能伴随高眼压的出现,因此术后需要长期随访观察.
목적 관찰연구일소수민족정분양파리체변성가계환자적림상특점급파리체절할수술연합시망막극격광광응적료효.방법 대2008～2012년재강소성중의원주진적3례래자동일소수민족가계적환자6지안행파리체절할수술연합시망막극격광광응치료.우술전급술후1～2년진행상세적안부검사,포괄시력、렬극등、안저경、광학상간단층소묘、형광소납안저혈관조영、안부B초급각막공초현미경.결과 6지안우술전균유시력엄중하강、파리체강내서상혼탁물、정상체후방“족반양혼탁”적전형표현.5지안적최가교정시력우술후체도1.0,단술후2년6지안균발현존재신적주변시망막병조.기중1지안출현파리체혼탁복발반수고안압증상,공취초현미재기각막내피후방발현고반광과립상물질침적.결론 국내파리체정분양변성환자적림상표현여국외보도존재일정구별,파리체절할수술능유효지치료해병,단술후시망막병변급파리체혼탁가능회복발,병가능반수고안압적출현,인차술후수요장기수방관찰.
Objective To study the clinical features of vitreous amyloidosis and the effect of vitrectomy combination with krypton laser photocoagulation.Methods Six eyes (3 Chinese minority nationality patients) with vitreous amyloidosis were treated using vitrectomy combination with krypton laser photocoagulation from 2008 to 2012,and followed up for 1-2 years after surgery.The examination included visual acuity,slit lamp,funduscope,optical coherence tomography (OCT),fluorescein fluorescein angiography (FFA),B-ultrasonography and in vivo confocal microscopy.Results All eyes showed symptoms characteristic of vitreous amyloidosis included severe hypopsia,vitreous opacities attaching to the posterior lens capsule by "foot-plate" and fundus lesion.Best corrected visual acuity of 5 eyes after vitrectomy reached to 1.0 and no severe complication was observed.Recurrence of fundus lesion occurred at 1 year postoperative in all 6 eyes and krypton laser photocoagulation were performed again.One eye showed recurrence of vitreous opacity and intraocular hypertension at 2 year post-operation and it had deposition of granule-like highly reflective materials on corneal endothelium with confocal microscopy.Conclusions There are some difference between domestic patients and foreign patients with vitreous amyloidosis.Vitrectomy is an effective and safe treatment but recurrence of fundus lesion and vitreous opacity after surgery should be noticed.Intraocular hypertension may occur in some patients postoperative,so a long time of follow-up after surgery should be performed.