Bonfioli Adriana A, Eller Andrew W
University of Pittsburgh Eye Center, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
Semin Ophthalmol. 2005 Jul-Sep;20(3):155-60. doi: 10.1080/08820530500232027.
Acute retinal necrosis (ARN) is an uncommon intraocular inflammatory syndrome characterized by severe and diffuse uveitis, retinal vasculitis, and retinal necrosis. It is typically described to occur in immunocompetent patients, but can also be found in immunocompromised subjects. Varicella-zoster virus (VZV), herpes simplex virus (HSV 1 and 2), cytomegalovirus (CMV), and Epstein-Barr virus (EBV) have been implicated in the etiology of ARN. The characteristic features of the disease include iridocyclitis, vitritis, retinal vasculitis, and retinal necrosis. Bilateral involvement occurs in two-thirds of the patients, frequently in the first six weeks, but sometimes months to years later. Retinal detachment occurs in 75% of the cases. The diagnosis of ARN is usually based in clinical features. The use of polymerase chain reaction (PCR) in aqueous humor samples is useful to identify the etiology of the disease. The treatment of ARN includes intravenous acyclovir, corticosteroids and aspirin. To prevent fellow eye involvement, intravenous acyclovir is followed by oral acyclovir for 14 weeks. Alternatives to acyclovir include ganciclovir, foscarnet, famcyclovir, brivudine, and valgancyclovir.
急性视网膜坏死（ARN）是一种罕见的眼内炎性综合征，其特征为严重且弥漫性的葡萄膜炎、视网膜血管炎和视网膜坏死。通常认为该病发生于免疫功能正常的患者，但也可见于免疫功能低下者。水痘-带状疱疹病毒（VZV）、单纯疱疹病毒（HSV 1和2）、巨细胞病毒（CMV）及EB病毒（EBV）都与ARN的病因有关。该病的特征性表现包括虹膜睫状体炎、玻璃体炎、视网膜血管炎和视网膜坏死。三分之二的患者会出现双侧受累，通常在前六周内，但有时也会在数月至数年之后。75%的病例会发生视网膜脱离。ARN的诊断通常基于临床特征。对房水样本进行聚合酶链反应（PCR）检测有助于明确该病的病因。ARN的治疗包括静脉注射阿昔洛韦、使用皮质类固醇和阿司匹林。为预防健侧眼受累，在静脉注射阿昔洛韦后，需口服阿昔洛韦14周。阿昔洛韦的替代药物包括更昔洛韦、膦甲酸钠、泛昔洛韦、溴夫定和缬更昔洛韦。
