Analysis on nine cases with acute retinal necrosis detected by optical coherence tomography

doi:10.3877/cma.j.issn.1674-1358.2019.06.010

Abstract

Abstract:

Objective

To investigate the fundus manifestation of patients with acute retinal necrosis (ARN) examined by optical coherence tomography (OCT).

Methods

OCT, best corrected visual acuity, slit lamp anterior segment examination, indirect ophthalmoscope after mydriasis, color fundus photography, visual field, corneal endothelial examination and fundus fluorescein angiography were performed for 9 patients with ARN. The fundus changes of OCT were analyzed.

Results

Total of 11 eyes fundus examination of 9 patients showed vitreous opacity, focal lamellar retinal necrosis of the fusion area, retinal vessel occlusion is white linear. The clinical diagnosis of ARN patients was based on typical fundus findings: yellow-white retinal necrosis, occlusive retinopathy, anterior chamber and vitreous inflammatory cells, etc. Patients with ARN were treated with acyclovir intravenously and vitrification in the event of retinal detachment.

Conclusions

The specific lesions observed on the OCT color fundus were consistent with the OCT images. Early and timely diagnosis and timely treatment of ARN patients by OCT could significantly improve their visual function and life quality.

Key words: Acute retinal necrosis, Optical coherence tomography, Fundus performance

Yu Dong, Yuehong Liu, Xuejing Xu, Binbin Liu. Analysis on nine cases with acute retinal necrosis detected by optical coherence tomography[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2019, 13(06): 512-514.

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References 15

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病例号	年龄	术前视力	眼底表现	OCT表现
1	46	右光感，左指数	玻璃体混浊、视盘边界不清、周边视网膜坏死、视网膜血管闭塞呈白线状，视网膜脱离	视网膜病变部位结构紊乱，视网膜内层高反射信号，黄斑区神经上皮层萎缩变薄，椭圆体带消失
2	58	0.15	玻璃体混浊、视盘边界不清、周边视网膜坏死	黄斑水肿
3	48	0.02	玻璃体混浊、视盘边界不清、周边视网膜坏死	黄斑区正常
4	58	0.01	玻璃体混浊、视盘边界不清、周边视网膜坏死、视网膜血管闭塞呈白线状	黄斑区视网膜神经上皮层脱离
5	56	0.08	玻璃体混浊、视盘边界不清、周边视网膜坏死、视网膜血管闭塞呈白线状	黄斑区正常
6	12	指数	玻璃体混浊、视盘边界不清、周边视网膜坏死、视网膜血管闭塞呈白线状，视网膜脱离	黄斑水肿
7	39	0.3	玻璃体混浊、视盘边界不清、周边视网膜坏死	黄斑区正常
8	30	手动	玻璃体混浊、视盘边界不清、周边视网膜坏死、视网膜血管闭塞呈白线状，视网膜脱离	视网膜病变部位结构紊乱，视网膜内层高反射信号，黄斑区神经上皮层萎缩变薄，椭圆体带消
9	49	光感	玻璃体混浊、视盘边界不清、周边视网膜坏死、视网膜血管闭塞呈白线状	视网膜病变部位结构紊乱，视网膜内层高反射信号，黄斑区神经上皮层萎缩变薄

病例号	年龄	术前视力	眼底表现	OCT表现
1	46	右光感，左指数	玻璃体混浊、视盘边界不清、周边视网膜坏死、视网膜血管闭塞呈白线状，视网膜脱离	视网膜病变部位结构紊乱，视网膜内层高反射信号，黄斑区神经上皮层萎缩变薄，椭圆体带消失
2	58	0.15	玻璃体混浊、视盘边界不清、周边视网膜坏死	黄斑水肿
3	48	0.02	玻璃体混浊、视盘边界不清、周边视网膜坏死	黄斑区正常
4	58	0.01	玻璃体混浊、视盘边界不清、周边视网膜坏死、视网膜血管闭塞呈白线状	黄斑区视网膜神经上皮层脱离
5	56	0.08	玻璃体混浊、视盘边界不清、周边视网膜坏死、视网膜血管闭塞呈白线状	黄斑区正常
6	12	指数	玻璃体混浊、视盘边界不清、周边视网膜坏死、视网膜血管闭塞呈白线状，视网膜脱离	黄斑水肿
7	39	0.3	玻璃体混浊、视盘边界不清、周边视网膜坏死	黄斑区正常
8	30	手动	玻璃体混浊、视盘边界不清、周边视网膜坏死、视网膜血管闭塞呈白线状，视网膜脱离	视网膜病变部位结构紊乱，视网膜内层高反射信号，黄斑区神经上皮层萎缩变薄，椭圆体带消
9	49	光感	玻璃体混浊、视盘边界不清、周边视网膜坏死、视网膜血管闭塞呈白线状	视网膜病变部位结构紊乱，视网膜内层高反射信号，黄斑区神经上皮层萎缩变薄

病例号	治疗方案	随访时间（月）	术后视力
1	静脉及双眼玻璃体腔注射更昔洛韦和膦甲酸钠左眼行玻璃体切除及硅油填充术	2	右无光感，左手动
2	静脉及玻璃体腔注射更昔洛韦	2.5	0.4
3	静脉及玻璃体腔注射更昔洛韦	1	0.5
4	静脉及玻璃体腔注射更昔洛韦和膦甲酸钠，行玻璃体切除及硅油填充术	3	0.1
5	静脉及玻璃体腔注射更昔洛韦	2.5	0.6
6	静脉及玻璃体腔注射更昔洛韦和膦甲酸钠，行玻璃体切除及硅油填充术	3	0.2
7	静脉及玻璃体腔注射更昔洛韦	17	0.6
8	静脉及玻璃体腔注射更昔洛韦和膦甲酸钠，行玻璃体切除及硅油填充术	1.5	指数
9	静脉及玻璃体腔注射更昔洛韦	4	指数

病例号	治疗方案	随访时间（月）	术后视力
1	静脉及双眼玻璃体腔注射更昔洛韦和膦甲酸钠左眼行玻璃体切除及硅油填充术	2	右无光感，左手动
2	静脉及玻璃体腔注射更昔洛韦	2.5	0.4
3	静脉及玻璃体腔注射更昔洛韦	1	0.5
4	静脉及玻璃体腔注射更昔洛韦和膦甲酸钠，行玻璃体切除及硅油填充术	3	0.1
5	静脉及玻璃体腔注射更昔洛韦	2.5	0.6
6	静脉及玻璃体腔注射更昔洛韦和膦甲酸钠，行玻璃体切除及硅油填充术	3	0.2
7	静脉及玻璃体腔注射更昔洛韦	17	0.6
8	静脉及玻璃体腔注射更昔洛韦和膦甲酸钠，行玻璃体切除及硅油填充术	1.5	指数
9	静脉及玻璃体腔注射更昔洛韦	4	指数

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