中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2013年
12期
919-921
,共3页
坏死,视网膜,急性%治疗
壞死,視網膜,急性%治療
배사,시망막,급성%치료
Necrosis,retinal,acute%Treatment
目的 探讨急性视网膜坏死病因及治疗.方法 就2例特殊类型急性视网膜坏死病例对本病进行分析.结果 病例1,左眼抗青光眼术后第1天视物不见,荧光素眼底血管造影提示急性视网膜坏死.B超显示:局限性视网膜隆起.给予抗病毒及糖皮质激素治疗.后葡萄膜炎症明显,血管闭塞,视网膜脱离.病例2,发热昏迷患者,颈项强直,脑膜刺激症阳性,行脑脊液检查,颅脑磁共振成像检查后考虑病毒性脑炎,经抗病毒、糖皮质激素治疗,意识逐渐好转后发现双眼视物不见,眼底屈光间质欠清,后极部视网膜水肿,似有隆起,并可见散在黄白色病灶,B超提示视网膜脱离.针对2例特殊急性视网膜坏死病例临床表现、不良预后,减少临床误诊及漏诊病例,认识该病治疗.结论 及时发现病情,早期足量、足疗程抗病毒治疗、预防性光凝、把握玻璃体手术时机是减少并发症有效手段.
目的 探討急性視網膜壞死病因及治療.方法 就2例特殊類型急性視網膜壞死病例對本病進行分析.結果 病例1,左眼抗青光眼術後第1天視物不見,熒光素眼底血管造影提示急性視網膜壞死.B超顯示:跼限性視網膜隆起.給予抗病毒及糖皮質激素治療.後葡萄膜炎癥明顯,血管閉塞,視網膜脫離.病例2,髮熱昏迷患者,頸項彊直,腦膜刺激癥暘性,行腦脊液檢查,顱腦磁共振成像檢查後攷慮病毒性腦炎,經抗病毒、糖皮質激素治療,意識逐漸好轉後髮現雙眼視物不見,眼底屈光間質欠清,後極部視網膜水腫,似有隆起,併可見散在黃白色病竈,B超提示視網膜脫離.針對2例特殊急性視網膜壞死病例臨床錶現、不良預後,減少臨床誤診及漏診病例,認識該病治療.結論 及時髮現病情,早期足量、足療程抗病毒治療、預防性光凝、把握玻璃體手術時機是減少併髮癥有效手段.
목적 탐토급성시망막배사병인급치료.방법 취2례특수류형급성시망막배사병례대본병진행분석.결과 병례1,좌안항청광안술후제1천시물불견,형광소안저혈관조영제시급성시망막배사.B초현시:국한성시망막륭기.급여항병독급당피질격소치료.후포도막염증명현,혈관폐새,시망막탈리.병례2,발열혼미환자,경항강직,뇌막자격증양성,행뇌척액검사,로뇌자공진성상검사후고필병독성뇌염,경항병독、당피질격소치료,의식축점호전후발현쌍안시물불견,안저굴광간질흠청,후겁부시망막수종,사유륭기,병가견산재황백색병조,B초제시시망막탈리.침대2례특수급성시망막배사병례림상표현、불량예후,감소림상오진급루진병례,인식해병치료.결론 급시발현병정,조기족량、족료정항병독치료、예방성광응、파악파리체수술시궤시감소병발증유효수단.
Objective To investigate the cause and treatment of acute retinal necrosis.Methods Cases series presentation.Results Patient 1:Lost vision in his left eye at 1 day after antiglaucoma surgery and presented with posterior uveitis,retinal vascular occlusion and retinal detachment.B-scan of ultrasonography showed localized retinal detachment.Fundus fluorescein angiography suggested acute retinal necrosis.This patient was treated with antiviral medication and corticosteroid.Patient 2:Presented with fever,coma,stiff neck and positive signs of meningeal irritation.The diagnosis of viral meningitis was confirmed by cerebrospinal fluid and MRI examination.This patient was also treated by antiviral medication and corticosteroid.After waking up,he complained of vision loss in both eyes and presented with retinal edema,retinal detachment and scattered yellow-white lesions on the retina.B-scan of ultrasonography showed retinal detachment.Conclusion Acute retinal necrosis should be diagnosed and treated early.Enough antiviral medication,prophylactic photocoagulation,timely vitreous surgery are the effective methods for avoiding the complications.
