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題 名 | Acute Retinal Necrosis Syndrome: Clinical Manifestations and Visual Outcomes=急性視網膜壞死之臨床表現及手術結果 |
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作 者 | 陳惠萍; 郭錫恭; 郭明倫; 陳勇仁; 蔡世豪; | 書刊名 | 長庚醫學 |
卷 期 | 27:3 2004.03[民93.03] |
頁 次 | 頁193-200 |
分類號 | 416.746 |
關鍵詞 | 急性視網膜壞死; 視網膜剝離; 周邊雷射治療; Acute retinal necrosis syndrome; Retinal detachment; Peripheral retinal photocoagulation; |
語 文 | 英文(English) |
中文摘要 | 背景:為了進一步描述急性視網膜病患之臨床特徵,視力之預後,手術治療的效果及癒後差者的危險因子。我們也回顧了目前常見的治療方式。 方法:這是個回顧分析,非比較性的觀察研究。包括1990年1月到2002年12月,在高雄長庚醫院的急性視網膜壞死之病患,共有9位病患(11隻眼睛)。病人血清及玻璃體檢體被收集加以分析,另外針對這些比患視網膜壞死的位置及手術結果加以探討。 結果:9位病患中2位是雙眼病例(2/9, 22.2%)。病人年齡與血清病毒抗體並無特關係,所有玻璃體檢體對單純泡疹病毒的多元聚合鍵反應都無特別發現。因急性視網膜壞死導致視網膜剝離而接受手術的6隻眼睛,術後都達到局部視網膜復位。總合來說,解剖構造的成功率佔了8/11(72.7%)。最後一次檢查可達行動視力的佔了4/11(36.3%),而保留住視力的佔了3/11(27.3%)。 結論:快速擴展到後極部的網膜壞死與較差的預後有關聯。視網膜壞死在二級範圍以內的是進行預防性周邊雷射治療的適當人選。早期正確診斷及即刻性的治療是保主視力的重要關鍵。 |
英文摘要 | Backgorund: In this paper we attempt to describe the clinical features, visual outcomes, and surgical results of patients with acute retinal necrosis (ARN) syndrome and elucidate the risk factors for a poor prognosis. We also review the methods of treatment. Methods: this was a retrospective, noncomparative, observational study of patients diagnosed with ARN syndrome. Nine patients (11 eyes) in Chang Gung Memorial Hospital, Kaoshiung from January 1990 to December of 2002 were enrolled. Blood sera and vitreous specimens were analyzed. Necrosis locations and surgical results are described. Results: Bilateral involvement occurred in 2 of our 9 patients (2/9, 22.2%). There was no specific relationship between age and level of the serum virus antibody. All of our polymerase chain reaction data for herpes simplex virus were negative. All 6 eyes of 6 patients who underwent surgery for retinal detachment had partial retinal reattachment postoperatively. Overall, anatomic success was achieved in 8 eyes (8/11, 72.7%). The percentage of eyes with ambulatory visual acuity was 36.3% (4/11), and visual acuity was preserved in 27.3%(3/11) at the last visit. Conclusions: We found that retinal necrosis which extended rapidly to the posterior pole was associated with a poor visual outcome. Eyes with less than grade II necrosis extension are good candidates for prophylactic peripheral retinal photocoagulation. Early detection and prompt treatment with acyclovir seems to improve the final visual outcome. |
本系統中英文摘要資訊取自各篇刊載內容。