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普尔夏视网膜病变:流行病学、临床特征及预后

Purtscher's retinopathy: epidemiology, clinical features and outcome.

作者信息

Agrawal Ashish, McKibbin Martin

机构信息

External Eye Diseases & Refractive Surgery, Manchester Royal Eye Hospital, Manchester, UK.

出版信息

Br J Ophthalmol. 2007 Nov;91(11):1456-9. doi: 10.1136/bjo.2007.117408. Epub 2007 Jun 7.

Abstract

AIMS

To study the incidence, systemic associations, presenting features and natural history of Purtscher's retinopathy in the UK and Ireland.

METHODS

Cases were collected prospectively by active surveillance through the British Ophthalmological Surveillance Unit. Clinical details were obtained using an incident questionnaire, with follow-up at 1 and 6 months.

RESULTS

Clinical details were obtained for 15 cases over 12 months. These were associated with road traffic accidents in 6 cases, chest compression in 6 cases and acute pancreatitis in 3 cases. All cases were symptomatic and presented with loss of visual acuity, visual field or a combination. Bilateral involvement was noted in 9 cases. The acute retinal signs of cotton wool spots, retinal haemorrhage and Purtscher flecken cleared within 1 month in 26% of eyes and within 6 months in all eyes. The most common chronic signs were optic disc pallor and atrophy of the retinal pigment epithelium. Without treatment, 50% of eyes improved by at least 2 Snellen lines at final follow-up and 23% improved by at least 4 Snellen lines. Only 1 of the 24 eyes had a final acuity worse than that recorded at presentation.

CONCLUSION

Purtscher's retinopathy is a rare but sight-threatening eye condition, most commonly seen in young or middle-aged men and after trauma. Spontaneous visual recovery of at least 2 Snellen lines is seen in half of the cases.

摘要

目的

研究英国和爱尔兰普尔彻视网膜病变的发病率、全身相关性、临床表现及自然病程。

方法

通过英国眼科监测单位的主动监测前瞻性收集病例。使用发病调查问卷获取临床细节,并在1个月和6个月时进行随访。

结果

在12个月内收集到15例的临床细节。其中6例与道路交通事故有关,6例与胸部挤压有关,3例与急性胰腺炎有关。所有病例均有症状,表现为视力丧失、视野缺损或两者兼有。9例为双侧受累。棉絮斑、视网膜出血和普尔彻斑等急性视网膜体征在26%的患眼中1个月内消退,所有患眼在6个月内消退。最常见的慢性体征是视盘苍白和视网膜色素上皮萎缩。未经治疗,在最后一次随访时,50%的患眼视力至少提高了2行斯内伦视力表读数,23%的患眼视力至少提高了4行斯内伦视力表读数。24只患眼中只有1只最终视力比初诊时记录的更差。

结论

普尔彻视网膜病变是一种罕见但威胁视力的眼部疾病,最常见于年轻或中年男性,且多在创伤后发生。半数病例视力可自发恢复至少2行斯内伦视力表读数。

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