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早期玻璃体切除术在进展性外层视网膜坏死中视网膜病变愈合中的作用。

The Role of Early Vitrectomy in the Healing of Retinal Lesions in Progressive Outer Retinal Necrosis.

作者信息

Riazi-Esfahani Hamid, Mirzaei Arash, Mirghorbani Masoud, Ghassemi Fariba, Zarei Mohammad, Khalili Pour Elias, Ebrahimiadib Nazanin

机构信息

Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Case Rep Ophthalmol Med. 2022 Feb 27;2022:7636052. doi: 10.1155/2022/7636052. eCollection 2022.

DOI:10.1155/2022/7636052
PMID:35265385
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8898816/
Abstract

PURPOSE

To report on the efficacy of early pars plana vitrectomy (PPV), silicone oil (SO) tamponade, and intravitreal ganciclovir injection in the treatment of a case with progressive outer retinal necrosis (PORN). . A 33-year-old man with a history of shingles on the chest skin 2.5 months ago presented with progressive vision loss in both eyes over the past 20 days. Fundus examination revealed retinal necrosis with perivascular clearance. Human immunodeficiency virus (HIV) infection was confirmed by western blot analysis. Treatment with intravenous acyclovir and intravitreal ganciclovir injections was unable to stop the progression of retinitis. Along with highly active antiretroviral therapy, the patient underwent PPV with SO tamponade and intravitreal ganciclovir injection in both eyes. A few days after surgery, retinal lesions started to improve.

CONCLUSION

Early PPV, SO tamponade, and intravitreal ganciclovir injection may be considered an effective intervention in PORN patients with an unfavorable response to medical treatment.

摘要

目的

报告早期玻璃体切除术（PPV）、硅油（SO）填塞及玻璃体内注射更昔洛韦治疗1例进行性外层视网膜坏死（PORN）患者的疗效。一名33岁男性，2.5个月前胸部皮肤曾患带状疱疹，在过去20天内双眼视力进行性下降。眼底检查发现视网膜坏死伴血管周围间隙。通过蛋白质印迹分析确诊为人类免疫缺陷病毒（HIV）感染。静脉注射阿昔洛韦及玻璃体内注射更昔洛韦治疗未能阻止视网膜炎进展。在高效抗逆转录病毒治疗的同时，该患者双眼接受了PPV联合SO填塞及玻璃体内注射更昔洛韦治疗。术后数天，视网膜病变开始改善。

结论

对于药物治疗反应不佳的PORN患者，早期PPV、SO填塞及玻璃体内注射更昔洛韦可能是一种有效的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54c8/8898816/88f221801d16/CRIOPM2022-7636052.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54c8/8898816/7f8533fc3c97/CRIOPM2022-7636052.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54c8/8898816/88f221801d16/CRIOPM2022-7636052.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54c8/8898816/7f8533fc3c97/CRIOPM2022-7636052.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54c8/8898816/88f221801d16/CRIOPM2022-7636052.002.jpg

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本文引用的文献

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Role of Prophylactic Vitrectomy in Acute Retinal Necrosis in Preventing Rhegmatogenous Retinal Detachment: Systematic Review and Meta-analysis.预防性玻璃体切除术在预防孔源性视网膜脱离中的作用：系统评价和荟萃分析。
Ocul Immunol Inflamm. 2022 Feb 17;30(2):515-519. doi: 10.1080/09273948.2020.1800051. Epub 2020 Sep 23.
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Experimental study on antiviral activity of silicone oil in vitro.
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Rapidly progressive outer retinal necrosis in the acquired immunodeficiency syndrome.获得性免疫缺陷综合征中的快速进展性外层视网膜坏死
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