Clinical Misdiagnosis of Acute Retinal Necrosis Syndrome
Objective To analyze the causes of clinical misdiagnosis of acute retinal necrosis syndrome(ARN)and the methods of correcting misdiagnosis,so as to improve the diagnosis rate of this disease.Methods The clinical data of 8 patients(8 eyes)with ARN who had been misdiagnosed from April 2021 to May 2023 were retrospectively analyzed.Results Among the 8 patients,3 patients were treated for left eye redness with visual acuity loss,1 patient was treated for left eye redness and blurred vision combined with headache,2 patients were treated for right eye redness,swelling pain and visual acuity loss,1 patient was treated for mild pain in the right eye,red eye with photophobia,tearing and foreign body sensation,and 1 patient was treated for blurred right eye with visual deformation.The initial diagnosis was iridocyclitis in 4 patients,panuveitis with retinal detachment in 1 patient,central retinal artery obstruction in the left eye(superior temporal branch)in 1 patient,hemorrhagic retinal vasculitis in the right eye in 2 patients.Among them,5 patients failed symptomatic treatment,4 patients were diagnosed with ARN by fundus examination and triple mirror examination,and 1 patient was diagnosed with ARN by fluorescence fundus angiography.ARN was diagnosed in 3 patients undergoing vitreous surgery.The misdiagnosis du-ration of 8 patients was 3 d-8 months.After diagnosis,5 patients were treated with antiviral and anticoagulation treatment,nu-tritional support and vitreous surgery,and 3 patients were treated with antiviral and anticoagulation treatment,nutritional sup-port and local laser photocoagulation of retinal necrosis lesions.After 12 months of follow-up,3 patients maintained retinal at-tachment,visual acuity recovered well,and the disease was not repeated.Five patients with retinal detachment were treated with flat vitrectomy.Conclusion The early symptoms of ARN are similar to iridocyclitis and hemorrhagic retinal vasculitis,which is prone to misdiagnosis.Clinicians should fully understand the clinical characteristics,diagnosis and differential diag-nosis of the disease,enhance vigilance,and perform necessary eye examination as soon as possible to reduce the early misdi-agnosis rate of the disease.
万方数据
维普
