CAJ | 학술논문

目的观察1例多发性一过性白点综合征患者的诊治病情变化,结合文献分析其临床特点.方法对2013年6月在中山大学中山眼科中心海南眼科医院确诊的1例多发性一过性白点综合征患者,分别于首诊时、发病25 d行最佳矫正视力、前置镜眼底检查,眼底照相,OCT、FFA与ICGA、视野及ERG检查,给予泼尼松片40 mg/d治疗.结果患者视力逐步提高,于45 d时矫正视力达1.0.眼底白点改变逐步消失,于发病25 d时已消失.中心视野检查患病早期出现生理盲点扩大,于25 d时恢复正常.ERG检查病变早期a波振幅明显降低,于25d仍明显降低,恢复缓慢.后极部OCT检查于患病早期出现视网膜色素上皮及视细胞外层(is与os连接,OPR)光带粗糙中断等改变.患病25 d,视网膜色素上皮及is与os连接光带逐步恢复,但OPR反光仍粗糙.病变早期视盘及静脉管壁高荧光于病程25 d时明显好转.结论多发性一过性白点综合征病理损害主要位于视网膜色素上皮层和视细胞层,可能是一种特殊类型脉络膜视网膜炎症性疾病,糖皮质激素能有效控制炎症,有利于缩短病程.
목적 관찰1례다발성일과성백점종합정환자적진치병정변화,결합문헌분석기림상특점.방법 대2013년6월재중산대학중산안과중심해남안과의원학진적1례다발성일과성백점종합정환자,분별우수진시、발병25 d행최가교정시력、전치경안저검사,안저조상,OCT、FFA여ICGA、시야급ERG검사,급여발니송편40 mg/d치료.결과 환자시력축보제고,우45 d시교정시력체1.0.안저백점개변축보소실,우발병25 d시이소실.중심시야검사환병조기출현생리맹점확대,우25 d시회복정상.ERG검사병변조기a파진폭명현강저,우25d잉명현강저,회복완만.후겁부OCT검사우환병조기출현시망막색소상피급시세포외층(is여os련접,OPR)광대조조중단등개변.환병25 d,시망막색소상피급is여os련접광대축보회복,단OPR반광잉조조.병변조기시반급정맥관벽고형광우병정25 d시명현호전.결론 다발성일과성백점종합정병리손해주요위우시망막색소상피층화시세포층,가능시일충특수류형맥락막시망막염증성질병,당피질격소능유효공제염증,유리우축단병정.
Objective To observe the change of treatment and to analyze its clinical characteristics of a multiple evanescent white dot syndrome.Methods A case of suspected multiple evanescent white dot syndrome was followed up in outpatient,best corrected visual acuity,fundus examination by preset lens,fundus photography,optical coherence tomography (OCT),fluorescein fundus angiography (FFA)/ indocyanine green angiography (ICGA),visual field and ERG were performed on the first visit and the 25th day,respectively.Prednisone 40mg was administrated.Results The visual acuity of the patient improved gradually,the corrected visual acuity was up to 1.0 on the 45th day.Fundus white dots disappeared gradually,and not to be discemed on the 25th day.Central visual field examination showed that physiological blind spot enlarged in the early stage,which returned to normal on the 25th day.ERG showed that amplitude of wave a decreased significantly in early stage,which still decreased and recovered slowly.OCT scan showed that optic band of retinal pigment epithelium (RPE) and inner photoreceptor segment/outer photoreceptor segment junction (is/os),outer segment photoreceptor/ retinal pigment epithelium complex (OPR) became rough and interrupt in early stage.Optic band of is/os and RPE restored gradually on the 25th day,but reflection of OPR was still rough.High fluorescence of optic disc and vein wall decreased significantly on the 25th day.Conclusions Multiple white spot syndrome can be a special type of chorioretinal inflammation,the pathological damage of which mainly located in the retinal pigment epithelial layer and the layer of photoreceptor cells.Glucocorticoid hormone can effectively control the inflammation,shorten the course of disease.