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急性视网膜坏死:哥伦比亚桑坦德参考中心的经验。

Acute Retinal Necrosis: Experience in a Reference Center in Santander - Colombia.

机构信息

Universidad Autónoma de Bucaramanga (UNAB), Bucaramanga, Santander, Colombia.

Fundación Oftalmológica de Santander Carlos Ardila Lule (FOSCAL), Floridablanca, Santander, Colombia.

出版信息

Ocul Immunol Inflamm. 2024 Sep;32(7):1342-1350. doi: 10.1080/09273948.2023.2244076. Epub 2023 Aug 15.

Abstract

INTRODUCTION

Acute retinal necrosis (ARN) is a severe eye disease demanding swift treatment to prevent blindness. Early action involving antiviral medications and corticosteroids is crucial for optimal visual outcomes.

OBJECTIVE

We present an ARN case series showcasing treatment experience and results.

METHODOLOGY

Patients diagnosed with ARN based on SUN Working Group 2021 criteria were included; all underwent comprehensive eye exams, PCR analysis, and imaging.

RESULTS

Eight patients were studied; PCR confirmed ARN in six. Induction treatment, either oral valacyclovir (5/8) or intravenous acyclovir (3/8), lasted 10-14 days. Maintenance included oral valacyclovir (6/8), oral valganciclovir (2/8) for six months, along with intravitreal ganciclovir. Visual outcomes were similar for oral and intravenous therapies; poor baseline acuity and macular involvement tend to result in a worse final acuity.

CONCLUSIONS

Swift treatment is vital to ARN management. Our findings emphasize effective treatment strategies' role in visual prognosis.

ABBREVIATIONS

ACV: Acyclovir; BCVA: Best Corrected Visual Acuity; CMV: Cytomegalovirus; EBV: Epstein Barr Virus; FTA-ABS: Fluorescent treponemal antibody absorption test; HSV 1-2: Herpes simplex virus 1-2; HIV: Human Immunodeficiency Virus; IV-ACV: Intravenous- Acyclovir; PCR: Polymerase Chain Reaction;Tg: ; VZV: Varicella Zoster Virus; VCV: Valacyclovir; VDRL: Venereal disease research laboratory test.

摘要

简介

急性视网膜坏死(ARN)是一种严重的眼部疾病,需要迅速治疗以防止失明。早期使用抗病毒药物和皮质类固醇的治疗措施对于获得最佳的视力结果至关重要。

目的

我们展示了一系列 ARN 病例,以展示治疗经验和结果。

方法

纳入基于 SUN 工作组 2021 年标准诊断为 ARN 的患者;所有患者均接受了全面的眼部检查、PCR 分析和影像学检查。

结果

研究了 8 例患者;PCR 证实了 6 例 ARN。诱导治疗持续 10-14 天,采用口服伐昔洛韦(5/8)或静脉注射阿昔洛韦(3/8)。维持治疗包括口服伐昔洛韦(6/8)、口服缬更昔洛韦(2/8)六个月,并进行玻璃体内注射更昔洛韦。口服和静脉治疗的视力结果相似;基线视力差和黄斑受累往往导致最终视力更差。

结论

快速治疗对于 ARN 的管理至关重要。我们的研究结果强调了有效的治疗策略在视力预后中的作用。

缩写词

ACV:阿昔洛韦;BCVA:最佳矫正视力;CMV:巨细胞病毒;EBV:Epstein Barr 病毒;FTA-ABS:荧光密螺旋体抗体吸收试验;HSV 1-2:单纯疱疹病毒 1-2;HIV:人类免疫缺陷病毒;IV-ACV:静脉注射-阿昔洛韦;PCR:聚合酶链反应;Tg:甲状腺球蛋白;VZV:水痘带状疱疹病毒;VCV:伐昔洛韦;VDRL:性病研究实验室试验。

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