Ermakova N A
Vestn Oftalmol. 2001 Jul-Aug;117(4):36-8.
Isolated retinal vasculitis (IRV) is a form of retinal vasculitis without other types of eye inflammation or systemic vasculitis. Treatment of IRV is a difficult problem. We report the results of treatment of 43 IRV patients (25 men and 18 women, mean age 32.5 +/- 5.5 years with a range of 22-42 years). The main therapy for IRV were corticosteroids. They were used by pulse therapy, orally and locally (periocular injections). Improvement of visual acuity was more pronounced in patients treated by pulse therapy (0.35 +/- 0.15) than in those treated orally (0.16 +/- 0.06, p = 0.0132) and parabulbarly (0.06 +/- 0.12, p = 0.0009). Resorption of retinal perivascular exudate was sooner achieved by steroid pulse therapy than by oral treatment (8.1 +/- 2.2 days vs. 17.9 +/- 2.8 days, p < 0.0000) or periocular injection of steroids (30.9 +/- 7.1 days, p < 0.0000). Prednisolone (10-20 mg) was prescribed for 4-12 months in order to prevent IRV recurrences. Steroid-resistant patients were treated with cyclosporin A (5 mg/kg). The treatment was supplemented by fibrinolytics, angioprotectors, and antioxidants.
孤立性视网膜血管炎（IRV）是一种无其他类型眼部炎症或系统性血管炎的视网膜血管炎形式。IRV的治疗是一个难题。我们报告了43例IRV患者（25例男性和18例女性，平均年龄32.5±5.5岁，范围为22 - 42岁）的治疗结果。IRV的主要治疗方法是使用皮质类固醇。它们通过脉冲疗法、口服和局部（眼周注射）使用。脉冲疗法治疗的患者视力改善更为明显（0.35±0.15），优于口服治疗（0.16±0.06，p = 0.0132）和球周注射治疗（0.06±0.12，p = 0.0009）。与口服治疗（8.1±2.2天对17.9±2.8天，p < 0.0000）或眼周注射类固醇（30.9±7.1天，p < 0.0000）相比，类固醇脉冲疗法能更快实现视网膜血管周围渗出物的吸收。为预防IRV复发，泼尼松龙（10 - 20毫克）需服用4 - 12个月。对类固醇耐药的患者用环孢素A（5毫克/千克）治疗。治疗辅以纤溶药物、血管保护剂和抗氧化剂。
