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脉络膜炎

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Results In 950 patients with successful cataractous operations,187 eyes(18.4%)had the vision of super-1.0,395 eyes(39.5%)had the Vision of 1.0-0.5,292 eyes(29.2%)had the vision of 0.5-0.3,106 eyes(10.4%)had the vision of 0.1-0.3,25 eyes(2.5)had the vislon of below-0.1.In 950 patients,242 eyes(24.2%)had diabetic retinopathy,15l eyes(15.1%)had aged-related macular degeneration,27 eyes(2.7%)had ischemic optic neuropathy,7 eyes(0.07%)had choroiditis,15 eyes(1.5%)had retinal vein occlusion,12 eyes(1.2%)had cystoid macular edema,5 eyes(0.2%)had traumatic retinopathy.

结果 950例患者的l 005只眼中,187只眼(18.4%)视力达1.0以上,395只眼(39.5%)视力在1.0-0.5,292只眼(29.2%)视力在0.5-0.3,106只眼(10.4%)视力在0.3-0.1,25只眼(2.5%)视力低于0.1.950例患者的1005只眼中,242只眼(24.2%)息有糖尿病视网膜病变,151只眼(15.1%)息有老年性黄班变性,27只眼(2.7%)息有缺血性视神经病变,7只眼(0.07%)息有陈旧性脉络膜炎,15只眼(1.5%)患有视网膜静脉闭塞,12只眼患有黄斑囊样水肿(1.2%),5只眼(0.05%)患有外伤性视网膜病变。

Objective To investigate the clinical features, causes of blindness and diagnosis of Vogt Koyanagi Harada syndrome Methods The data of 157 patients with VKH syndrome were reviewed and analyzed Patients were carefully examined with slit lamp, ophthalmoscope, three mirror lens, fundus fluorescein angiography, indocyanine green angiography and HLA typing Results Headache was noted in 73 5% of these patients Simultaneous involvement of both eyes occurred in 80 8% of these patients Chroiditis,papilledema and edema of the retina adjacent to the optic nerve were noted in 100% of these patients in the posterior uveitis stage, whereas recurrent granulomatous anterior uveitis (98 4%),"sunset glow" fundus (95 8%) and Dalen Fuchs nodules (71 2%) were the common ocular findings in the recurrent anterior uveitis stage The common causes of blindness were papillitis, exudative retinal detachment and complicated cataract in the posterior uveitis stage, anterior uveal involvement stage and its recurrent stage Poliosis (36 3%) and alopecia (35 0%) were the most common extraocular findings Early irregular patches of fluorescence, followed by localized hyperfluorescent spots were the typical findings of FFA Dilation of choroidal vessels and leakage of ICG from the choroidal vessels were the common ICGA findings The prevalence of HLA DR4 and HLA DRw53 in patients (54 9% and 71 8% respectively) was significantly higher than that in controls (14 7% and 38 2% respectively) Conclusions VKH syndrome is characterized by chroiditis, papillitis or neuroretinitis in the posterior uveitis stage, followed by a generalized uveitis with a typical recurrent granulomatous anterior uveitis Extraocular findings and relevant examinations including FFA, ICGA and HLA typing are helpful to the diagnosis of VKH syndrome

目的探讨Vogt-Koyanagi-Harada综合征患者的临床特征、盲目原因及诊断等有关问题。方法对在1996年1月至2000年12月间就诊资料完整的157例VKH综合征患者进行回顾性分析,并对裂隙灯、眼底镜、三面镜、荧光素眼底血管造影(fundus fluorescein angiography,FFA)、吲哚青绿血管造影(indocyanine green angiography,ICGA)及人类白细胞抗原分型等检查结果进行分析。结果 VKH综合征最常见的前驱症状为头痛(102例,73.5%),双眼同时患病118例(80.8%);后葡萄膜炎期眼部主要表现为脉络膜炎、视乳头及附近视网膜水肿(100.0%);前葡萄膜炎反复发作期眼部表现为复发性肉芽肿性前葡萄膜炎(128例,98.4%)、晚霞状眼底改变(95.8%)及Dalen-Fuchs结节(71.2%);后葡萄膜炎期、前葡萄膜受累期及前葡萄膜炎反复发作期导致盲目的主要原因分别为视乳头炎、视网膜脱离及并发性白内障;毛发变白(36.3%)及脱发(35.0%)是最常见的眼外表现;炎症活动期FFA典型表现为斑驳状高荧光,ICGA发现脉络膜血管扩张、通透性增高等改变;VKH综合征患者HLA-DR4及HLA-DRw53的阳性率(54.9%及71.8%)显著高于正常对照组(14.7%及38.2%)。结论 VKH综合征患者在后葡萄膜炎期眼部典型表现为双侧脉络膜炎、视乳头炎或神经视网膜炎,随后出现以反复发作的肉芽肿性前葡萄膜炎为特征的全葡萄膜炎。眼外症状及相关的辅助检查包括FFA、ICGA 及HLA分型等有助于VKH综合征的诊断。

Research background: Choroidal neovascularization is a common cause of vision loss in patients, which often resulted from exudative Age-related macular degeneration、 pathologic myopia、 central serous chorioretinopathy、ocular histoplasmosis and angioid streaks, Rarely, CNV is seen in children, usually in association with inherited macular dystrophies. Despite extensive basic and clinical research, our knowledge of the complicated molecular mechanism of CNV is still limited, for these reasons currently used therapeutic approaches are insufficiently effective.

课题研究背景:脉络膜新生血管(choroidal neovascularization,CNV)是导致视力丧失的一种常见原因,多继发于渗出型年龄相关性黄斑变性、近视性黄斑变性、中心性浆液性脉络膜视网膜炎、眼组织胞浆菌病和眼底血管样条纹等眼病,在儿童罕见,主要与遗传性黄斑营养不良有关,尽管近年来进行了大量的基础和临床研究,但对CNV复杂分子机制的认识仍然非常有限,因此目前的治疗措施都不尽如人意。

Although the operation was quite smooth and uneventful, the patient also suffered from severe iritis and uveal effusion post-operatively.

虽然手术过程很顺利,但病患在术后还是发生了严重的虹膜炎和脉络膜水肿:另外,经过检查,病患没有全身性的免疫发炎相关问题。

Methods : The study included 12 patients (24 eyes) with WNV-associated chorioretinitis.

研究对象为12名西尼罗病毒相关的脉络膜视网膜炎患者。

But the drug can cause neutropenia, thrombocytopenia, abnormal liver function, chorioretinitis, side effects such as bacterial infection.

但药物可以引起白细胞减少,血小板减少、肝功能异常、脉络膜视网膜炎、细菌感染等副作用。

Results 2 years later the two group infants were observed with the prognosis (such as sensorineural hearing loss, mental retardation and other neurological abnormalities, chorioretinitis, eye shrinkage, liver cirrhosis and death, etc).

结果:2年后观察两组患儿预后(如感觉神经性耳聋、智力低下和其他神经系统异常、脉络膜视网膜炎、眼球萎缩、肝硬化及死亡等)。

TNF-α ASON treating HSV-Ⅰinduced chorioretinitis may reduce the content of TNF-α in affected mice eyes and decrease the inflammatory reaction.Chin J Ocul Fundus Dis,

采用作用于TNF-α的反义寡核苷酸局部治疗小鼠单疱病毒性脉络膜视网膜炎,能明显降低感染小鼠眼内细胞因子TNF-α的含量,减轻眼内脉络膜视网膜炎症反应。

The patients include 10 patients(20 eyes) of VogtKoyanagiHarada syndrome, 1 patients(2 eyes) of Behcet diseases, 11 patients(21 eyes) of other uveitis, 5 patients (9 eyes) of papolloedema, 2 patients(2 eyes) of choroidal tumor, 2 patients(4 eyes) of, hypotony with macular degeneration, 1 patient(2 eyes) of,Graves diseases, 1 patient (1 eye) of,blunt trauma and 1 patient(1 eye) of uveal effusion syndrome.

其中伏格特-小柳-原田综合征10例20只眼,Behccet病1例2只眼,其他类型葡萄膜炎11例21眼,视盘水肿5例9只眼,脉络膜肿瘤2例2只眼,低眼压性黄斑病变2例4只眼,Graves眼病1例2只眼,眼钝挫伤1例1只眼,脉络膜渗漏综合征1例1只眼。

Fluorescein and indocyanine green fundus angiography were used to evalute the macular morphologic results. Results The result of fundus angiography showed that 90 cases 98 eyes had choroidal neovacularization, There were exudation age-related macular degeneration 39 cases (44 eyes), idophaic CNV 23 cases (23 eyes) and highly myopia 22 cases (25 eyes), Polypoidal Choroidal Vasculpathy 4cases (4eyes), multifocal choroidit 1 case (1 eye )and nodifferentiate 1 cases.

结果 90例98只眼黄斑部出血患者的眼底血管造影结果显示有脉络膜新生血管,其中老年黄斑变性湿性型39例44只眼,中心性渗出性脉络膜视网膜病变23例23只眼,高度近视22例25只眼,息肉状脉络膜血管病变4例4只眼,多灶性脉络膜炎1例1只眼,诊断不明1例。

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