Ahmadieh Hamid, Soheilian Masoud, Azarmina Mohsen, Dehghan Mohammad H, Mashayekhi Arman
Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Jpn J Ophthalmol. 2003 Sep-Oct;47(5):484-91. doi: 10.1016/s0021-5155(03)00139-4.
To describe the clinical features of complicated retinal detachment secondary to acute retinal necrosis (ARN) and to present the long-term results of vitreous surgery in these cases.
A retrospective study was conducted on 16 immunocompetent patients (18 eyes). The average follow-up period was 60 months.
Proliferative vitreoretinopathy (PVR) grade C, with the predominance of anterior PVR, and characteristic changes in the vitreous base area were present in all cases before surgery. All eyes underwent vitrectomy, membrane peeling, endolaser photocoagulation, and intraocular tamponade without scleral buckling. Additional procedures were performed in 13 eyes. Retinal reattachment was achieved in the 18 eyes (100%) in the short term. Variable degrees of reproliferation occurred in all cases after surgery. Other delayed complications included ocular hypotony, macular pucker, peripheral retinal neovascularization, and severe preretinal fibrosis. Improvement of visual acuity occurred in 13 eyes (72.2%). Eleven eyes (61.1%) achieved final ambulatory visual acuity of 5/200 or better.
Rhegmatogenous retinal detachment secondary to ARN has characteristic clinical features. Severe proliferative vitreoretinopathy with the predominance of anterior PVR develops rapidly. Reproliferation is the most important late postvitrectomy complication necessitating multiple surgical procedures in these cases. The visual results remain unfavorable due to the destructive nature of ARN.
描述急性视网膜坏死（ARN）继发复杂性视网膜脱离的临床特征，并呈现这些病例玻璃体手术的长期结果。
对16例免疫功能正常的患者（18只眼）进行回顾性研究。平均随访期为60个月。
所有病例术前均存在C级增殖性玻璃体视网膜病变（PVR），以前部PVR为主，且玻璃体基底部有特征性改变。所有眼均接受了玻璃体切除术、膜剥除术、眼内激光光凝和眼内填充，未行巩膜扣带术。13只眼还进行了其他手术。18只眼（100%）短期内实现了视网膜复位。所有病例术后均出现不同程度的再增殖。其他延迟性并发症包括低眼压、黄斑皱襞、周边视网膜新生血管形成和严重的视网膜前纤维化。13只眼（72.2%）视力有所改善。11只眼（61.1%）最终的可走动视力达到5/200或更好。
ARN继发的孔源性视网膜脱离具有特征性临床特征。以前部PVR为主的严重增殖性玻璃体视网膜病变发展迅速。再增殖是玻璃体切除术后最重要的晚期并发症，在这些病例中需要多次手术。由于ARN的破坏性，视力结果仍然不佳。
