IRVAN综合征的临床特征和治疗.pdf

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1、眼科研究2006年4月第24卷第2期

191

临床研究
IRVAN综合征的临床特征和治疗王光璐
卢
宁
王明扬ClinicalfeatureandtreatmentofIRVANsyndromeWangGuanglu,LuNing,WangMingyang.BeijingTongrenOphthalmicCenter,TongrenHospital,CapitalUniversityofMedicalSciences,Beijing100730,China

Abstract
Objective
Idiopathicret

2、inalvasculitis,aneurysmsandneuroretinitis(IRVAN)syndromebelongstoanidiopathicretinalvasculitis.ThispaperwastodescribetheclinicalfeaturesofIRVANsyndromeandevaluatethetherapeuticeffectoflaserphoto
coagulationonthecaseswithIRVANsyndrome.
Methods
Clinicalexaminationswer

3、eperformedon26eyesof13caseswithIRVANsyndrometoobservetheclinicalfeaturesofIRVANsyndrome.Variouskindsoflaboratoryevaluations,transcranialDopplerultrasonography,nailplicamicrocirculationexaminationwasalsoperformedtofindpathogeneticcauseofIRVANsyndrome.Laserphoto
coagu

4、lationwasusedin19eyes.Anti
tuberculosisdrugswereusedfor1yearin2eyesof1casetoevaluateitstherapeuticeffect.Theaveragefollow
updurationwas33
3months.
Results
Outof13cases,5weremale,8werefemale.12caseswerebetween20-40years.Thevisualacuitywas
5/100in7eyes(26
9%),6/100-20

5、/100in1eye(3
9%)and
20/60in18eyes(69
2%).Mildaqueousflarewasseenin3eyes(irisneovascularization).Aneurismaldilatationoraneurysmontheopticdickin18eyes(90%)andatornearthemajorbranchingofarteriolesin16eyes(80%).Everycasecertainlyhadaneurysmseitherontheopticdiskoronthema

6、inbranchingofthearteriolesorboth.FFAshowedhyperfluorescenceonthedisk,veinwallstainingandalargenon
perfusionareaintheperiphery,displayingahypofluorescentareawithazigzaghyperfluorescentborder.Thevisualacuityof16eyes(84
2%)afterlasertreatmentkeptunchangedorslightlyimpr

7、oved.NOpositivelaboratoryoutcomerelevanttopathogenesiswasgained.
Conclusion
AllcasesarecompatiblewiththediagnosisofIRVANsyndrome.Laserphoto
coagulationisabletosloworstabilizethedevelopmentofthisdisorder.Oralanti
tuberculosisdrugsappeartohavelittleeffect.Earlydiagnos

8、isandpropertreatmentarethekeytogetgoodsight.

Keywords
IRVANsyndrome;retinalvasculitis;retinalaneurysm;Ealesdisease摘要
目的
介绍IRVAN综合征的临床特点并评