急性视网膜坏死综合征二例误诊分析
Analysis of Clinical Misdiagnosis of 2 Patients with Acute Retinal Necrosis Syndrome
李咏 1张丁 1林慧 1白云冬 1李茜1
作者信息
- 1. 071000 河北 保定,陆军第 82 集团军医院眼耳鼻喉科
- 折叠
摘要
目的 分析急性视网膜坏死综合征(ARNS)的临床特点及容易引起误诊的原因,并总结防范误诊措施,以提高早期诊断正确率.方法 回顾分析2021 年3 月至2023 年9 月收治的一度误诊为青光眼、眼内炎的ARNS 2 例病例资料.结果 1 例以右眼视物不清3 月余就诊,1 例因左眼红、眼痛 4d急性发病入院.就诊初期一度误诊为青光眼、眼内炎,予相应治疗效果不佳,后经手术及眼底检查、光学相干断层成像检查,明确诊断为ARNS.误诊时间4d至2 个半月.确诊后经抗病毒药物、糖皮质激素等治疗出院,预后尚可.结论 ARNS病情进展较迅速且预后较差,是严重的致盲性眼病,而早期临床表现缺乏特异性,易误诊;加强对ARNS的认识,提高警惕性,仔细鉴别诊断,及时行相关医技检查,全面分析病情,避免早期误诊.
Abstract
Objective To analyze the clinical characteristics of acute retinal necrosis syndrome(ARNS)and the causes of misdiagnosis,and to summarize the preventive measures,so as to improve the accuracy of early diagnosis.Methods The data of 2 patients with ARNS misdiagnosed as glaucoma and endophthalmitis from March 2021 to September 2023 were retrospectively analyzed.Results One patient presented with blurred vision in the right eye for more than 3 months,and 1 patient was admitted to hospital with acute onset of red left eye and eye pain for 4 d.At initial hospital visit,it was misdiag-nosed as glaucoma and endophthalmitis,and the corresponding treatment was not effective.After surgery,fundus examination and optical coherence tomography,the diagnosis was confirmed as ARNS.The duration of misdiagnosis was 4 d to 10 weeks.After diagnosis,he received treatment with antiviral drugs and glucocorticoids,and was discharged from hospital,with favora-ble prognosis.Conclusion ARNS is a serious blinding eye disease with rapid progression and poor prognosis,and early clin-ical manifestations lack specificity,which is prone to misdiagnosis.It is necessary to strengthen the understanding of ARNS,enhance vigilance,and perform careful differential diagnosis,timely relevant medical examination and comprehensive analysis of the condition,to avoid early misdiagnosis.
关键词
视网膜坏死,急性/误诊/青光眼/眼内炎/鉴别诊断/眼底检查/光学相干断层成像检查Key words
Retinal necrosis,acute/Misdiagnosis/Glaucoma/Endophthalmitis/Differential diagnosis/Fundus ex-amination/Optical coherence tomography引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据