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[多灶性脉络膜炎:诊断要点及光凝治疗结果。附25例报告]

[Multifocal choroiditis: diagnostic aspects and results of photocoagulation. Apropos of 25 cases].

作者信息

Delayre T, Soubrane G, Ramahefasolo C, Coscas G

机构信息

Clinique Ophtalmologique Universitaire de Créteil, Université de Paris XII, Créteil, France.

出版信息

J Fr Ophtalmol. 1989;12(2):97-102.

PMID:2794358
Abstract

A retrospective study was conducted on 25 patients who presented with both recurrent multifocal choroiditis and subretinal neovascularisation. As in other series, striking features were the young age of the patients (mean age 33 years), frequent recurrences of the macular lesions during a limited follow-up period, inflammation of the vitreous or the optic disk, and macular fibrosis. However, unlike previously reported data, refraction was more often in the emetropic range, there was no female predominance, and inflammatory signs were mild or limited to papillitis. Moreover serologic tests did not indicate an acute infection due to Epstein-Barr virus in any of the patients. This study also emphasized the results of Krypton laser treatment of the subretinal neovascularisation. Final visual acuity improved or remain the same in 26 eyes (72%) and worsened in 11 eyes (28%) during a mean follow-up period of 13 months (range 2-48 months). The best results were obtained in 15 eyes with neovascular membranes located more than 200 mu from the foveal avascular zone (mean final visual acuity: 20/40). However the mean final visual acuity of the nine eyes with neovascular membranes closer than 200 mu from the FAZ, was over 20/60. Recurrences of subretinal neovascularisation occurred in 7 out of 24 treated eyes and 3 were under the center of the FAZ. These results should be confirmed by a randomized prospective clinical trial in order to assess the benefits of laser treatment in recurrent multifocal choroiditis.

摘要

对25例患有复发性多灶性脉络膜炎和视网膜下新生血管形成的患者进行了一项回顾性研究。与其他系列研究一样,显著特征包括患者年龄较轻(平均年龄33岁)、在有限的随访期内黄斑病变频繁复发、玻璃体或视盘炎症以及黄斑纤维化。然而,与先前报道的数据不同的是,屈光状态更常处于正视范围,没有女性 predominance,炎症体征较轻或仅限于视乳头炎。此外,血清学检查未显示任何患者存在由EB病毒引起的急性感染。本研究还强调了氪激光治疗视网膜下新生血管形成的结果。在平均13个月(范围2 - 48个月)的随访期内,26只眼(72%)的最终视力改善或保持不变,11只眼(28%)的视力恶化。对于15只新生血管膜距离黄斑无血管区超过200微米的眼睛,获得了最佳结果(平均最终视力:20/40)。然而,9只新生血管膜距离FAZ小于200微米的眼睛,平均最终视力超过20/60。24只接受治疗的眼睛中有7只出现视网膜下新生血管形成复发,3只位于FAZ中心下方。这些结果应通过随机前瞻性临床试验来证实,以便评估激光治疗复发性多灶性脉络膜炎的益处。

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