Mizuuchi Kazuomi, Namba Kenichi, Kotake Satoshi, Ohno Shigeaki
Department of Ophthalmology and Visual Sciences, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Nippon Ganka Gakkai Zasshi. 2008 Feb;112(2):136-40.
To study clinical features of acute retinal necrosis (ARN) at Hokkaido University Hospital.
Twenty-one eyes of 19 patients with ARN (10 male and 9 female patients) who were treated at Hokkaido University Hospital between 1992 and 2006 were retrospectively examined from clinical records.
The average age of the patients was 53.4 years (range, 13 to 91 years). 17 cases were unilateral and 2 were bilateral. The pathogenic virus was herpes simplex virus-1 (HSV-1) in 2 patients, and varicella-zoster virus (VZV) in 17 patients. Clinical severity was assessed from spreading speed and area of the retinal exudation, and 5 eyes were judged as fulminant cases (4 VZV eyes, 1 HSV eye), 6 eyes as severe cases (6 VZV eyes), and 10 eyes as mild cases (9 VZV eyes, 1 HSV eye). The range of retinal exudation was 1 to 2 quadrants in 7 eyes, 3 to 4 quadrants in 3 eyes, and increased to all quadrants in 11 eyes. Retinal detachment (RD) was observed in 8 eyes (38%), and the final visual acuity was less than 0.1 in 9 eyes (43%).
The leading cause of ARN at Hokkaido University Hospital was VZV, and no HSV-2 ARN was seen. Compared with other areas in Japan, ARN at Hokkaido University Hospital seems to show less frequent RD, but the same prognosis for final visual acuity.
研究北海道大学医院急性视网膜坏死（ARN）的临床特征。
对1992年至2006年期间在北海道大学医院接受治疗的19例ARN患者（10例男性，9例女性）的21只眼进行回顾性临床记录检查。
患者的平均年龄为53.4岁（范围13至91岁）。17例为单侧，2例为双侧。致病病毒为单纯疱疹病毒1型（HSV - 1）的有2例患者，水痘 - 带状疱疹病毒（VZV）的有17例患者。根据视网膜渗出的扩散速度和范围评估临床严重程度，5只眼被判定为暴发型（4只VZV眼，1只HSV眼），6只眼为严重型（6只VZV眼），10只眼为轻型（9只VZV眼，1只HSV眼）。视网膜渗出范围为1至2个象限的有7只眼，3至4个象限的有3只眼，累及所有象限的有11只眼。8只眼（38%）观察到视网膜脱离（RD），9只眼（43%）最终视力低于0.1。
北海道大学医院ARN的主要病因是VZV，未发现HSV - 2所致的ARN。与日本其他地区相比，北海道大学医院的ARN似乎视网膜脱离发生率较低，但最终视力预后相同。
