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双语推荐:交感性眼炎

目的 分析玻璃体切除术后交感性眼炎的临床特征.方法 回顾性分析璃体切除术后交感性眼炎13例的临床资料.结果 发生交感性眼炎的时间距最后一次玻璃体手术时间为10 d~2年,4个月以内者8例(61.5%),临床表现以视力下降为主,其次为眼痛、眼前黑影、视物变形.发病时感眼视力为0.04 ~0.6,激发眼视力为无光感~数指.4例感眼有渗出性视网膜脱离.所有患者经糖皮质激素治疗后感眼和激发眼视力均有不同程度恢复.3例因激发眼视力完全丧失而行眼球摘除术.结论 玻璃体切除术后交感性眼炎发生率为0.29%;大多发生在手术后4个月以内;术中联合晶状体手术、巩膜外冷凝、术前存在眼外伤和其它手术史,增加发生交感性眼炎的危险.
Objective To analyse the chnical manifestations of sympathetic ophthalmia after pars plana vitretomy.Methods Retrospective study was performed in 13 cases with sympathetic ophthalmia who had undergone pars plana vitrectomy.Results The interval time from the last vitrectomy to the occurrence of sympathetic ophthalmia ranged from 10 days to 2 years,8 cases (61.5%) occurred within 4 months.The decrease of visual acuity took the first place in clinical manifestations,followed by opthalmalgia,spotted vision and visual distorsion.The visual acuity was from 0.04 to 0.6 in sympathetic eyes,and no light perception to counting finger in the exiting eyes.4 sympathetic eyes had exudative retinal detachment.The visual acuity increased partly in the sympathetic eyes and the exiting eyes after treatment with steroid.Three patients had undergone enucleation of exiting eyes because of total loss of visual acuity.Conclusion The incidence of sympathetic ophthalmia after vitrectomy is low,about

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交感性眼炎是一眼发生眼球穿通伤或内眼手术后引起的双眼非坏死性肉芽肿性葡萄膜炎。可隐匿发病也可急性发病。交感性眼炎临床表现多变,病情易于反复恶化,并可能致盲。典型的临床表现为羊脂状角膜后沉着物,脉络膜渗出及Dalen—Fuchs结节。组织学上表现为弥漫性或肉芽肿性葡萄膜炎症反应。目前的治疗包括药物治疗及手术治疗。发病机制目前尚未完全清楚。多认为是激发眼引起的自身免疫反应导致感眼发病。
Sympathetic ophthalmia is a rare bilateral granulomatous inflammation that follows accidental or surgical insult to the uvea of one eye.Onset of sympathetic ophthalmia can be insidious or acute,with variable clinical manifestations.Sympathetic ophthalmia can deteriorate repeatedly and induce blindness.Clinical presentation shows mutton-fat keratic precipitates,choroidal infiltrations,and Dalen-Fuchs nodules.Histopathology reveals diffuse or nodular granulomatous inflammation of the uvea.Prevention and treatment strategies for sympathetic ophthalmia include medicine and surgery.The mechanism of the disease is still unclear but is largely thought to be autoimmune in nature.

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目的 观察葡萄膜炎患者黄斑区病变光相干断层扫描(OCT)图像特征.方法 2011年5月至2012年5月临床明确诊断的葡萄膜炎患者51例78只眼纳入研究.其中,男性28例,女性23例;平均年龄(46.75±13.22)岁;病程1~24个月.前葡萄膜炎16例21只眼;小柳-原田综合症12例23只眼;Beh(c)et病6例10只眼;交感性眼炎5例5只眼;其他后葡萄膜炎12例19只跟.患眼均行常规眼科检查及频域OCT检查,典型图像存盘分析.根据检查结果将黄斑区病变分为黄斑水肿、黄斑前膜形成、浆液性神经上皮脱离、黄斑区萎缩、黄斑板层裂孔、脉络膜新生血管(CNV).结果 78只眼中,黄斑区水肿48只眼,占患眼的61.5%.其中,黄斑囊样水肿33只眼;黄斑弥漫性水肿15只眼.黄斑前膜22只眼,占患眼的28.2%.脉络膜新生血管4只眼,占患眼的5.1%.黄斑裂孔4只眼,占患眼的5.1%.黄斑萎缩10只眼,占患眼的12.8%.浆液性神经上皮脱离22只眼,占患眼的28.2%.结论 葡萄膜炎患者黄斑区OCT表现具有多种形态特征.
Objective To observe the characteristics of optical coherence tomography (OCT) of the macular in uveitis patients.Methods A total of 51 cases (78 eyes) of uveitis admitted to affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine from May 2011 to May 2012 were reviewed retrospectively.All patients were underwent OCT examination and classified according to characteristics of OCT.Results The characteristics of OCT in uveitis were classified into six groups.Macular edema including cystoid macular edema and diffuse edema was detected in 48 eyes (61.5%).Macular epiretinal membrane was found in 22 eyes (28.2%).Choroidal neovascularization and macular hole was found in 4 eyes (5.1%),respectively.Ten eyes (12.8%) showed macular atrophy and 22 eyes (28.2%) showed serous neuroepithelium detachment.Conclusions Macular OCT in uveitis patients displayed different morphological characteristics.

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探讨基层医院开放性眼外伤的易感人群、原因、就诊时间、处理方法及意义。方法:2009年7月-2013年8月收治开放性眼外伤患者105例(105只眼),对其进行回顾性分析。结果:6只眼非手术治疗,99只眼手术治疗,其中6只眼修复伤口及时转院,4只眼行眼球摘除,交感性眼炎2例,治疗后视力≥0.05者42只眼。结论:基层医院是开放性眼外伤的主要首诊治疗场所,首次处理是否得当对伤眼的预后有直接关系,受伤者多为儿童、学生和农民,加强安全防护和教育,可减少眼外伤的发生,伤后及时就诊和正确处理,可减少开放性眼外伤的致盲率。
Objective:To investigate the susceptible population,causes,treatment time,treatment methods and significance of the ocular trauma in primary hospital.Methods:105 cases (105 eyes) of ocular trauma were selected from July 2009 to August 2013. Their data were analyzed retrospectively.Results:6 eyes were given non operation treatment,and 99 eyes were given operation treatment,including 6 eyes of repairing the wound and transfer timely,4 eyes of underwent enucleation,2 cases of sympathetic ophthalmia,visual acuity≥0.05 in 42 eyes.Conclusion:Primary hospital are the initial diagnosis and treatment places for ocular trauma,whether appropriate of the first treatment is directly related to prognosis of eye injury.Most of the injured are children, students and farmers.Strengthen the safety protection and education can reduce the occurrence of eye injury.Timely and proper treatment after ocular trauma can reduce the blindness of ocular trauma.

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