微视野在急性全葡萄膜炎激素冲击治疗前后的应用
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Clinical application of microperimetry before and after glucocorticoid pulse therapy for acute pan-uveitis
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    摘要:

    目的:评价微视野在急性全葡萄膜炎病程发展及治疗效果观察中的临床意义及应用价值,为微视野的临床应用提供依据。

    方法:收集就诊时间在发病5d内的急性全葡萄膜炎患者53例106眼。采集激素冲击治疗前,激素冲击治疗后1,3,7d; 1,3mo的裸眼视力、最佳矫正视力、微视野图像和光学相干断层扫描(OCT)及Flare检查结果,并对数据进行分析。观察并分析激素冲击治疗前后视力、光敏感度参数的变化、黄斑区水肿由严重到消退的过程及房水细胞值的变化。

    结果:急性全葡萄膜炎患者经过治疗,炎症逐渐消退,激素冲击治疗后1,3,7d; 1,3mo采集数据较激素冲击治疗前有明显好转,差别有统计学意义(P<0.05)。患者于不同时期视力逐渐提高; 治疗后黄斑区视网膜神经上皮层的厚度,由281±61μm变为149±43μm,差别有统计学意义(P=0.000); Flare结果由213.9±13.8变为18.2±2.2,差别有统计学意义(P=0.000)。

    结论:微视野可客观揭示急性全葡萄膜炎患者激素冲击治疗前后眼的视力及光敏感度的变化,为急性全葡萄膜炎病程发展及治疗效果的观察提供重要信息。

    Abstract:

    AIM:To evaluate microperimetry in treatment of acute pan-uveitis patients before and after glucocorticoid pulse therapy, and to provide evidence for the clinical application of microperimetry.

    METHODS:Fifty-three patients(106 eyes)with acute pan-uveitis who came to hospital within 5 days of onset were enrolled. The data of visual acuity, best corrected visual acuity, microperimetry images, OCT and flare examination outcome were analyzed before glucocorticoid pulse therapy and 1, 3, 7d, 1 month and 3 months after the therapy. The changes in visual acuity, light sensitivity, cell value of aqueous humor and macular edema were observed.

    RESULTS: In patients with acute pan-uveitis, inflammation subsided gradually after treatment. Compared with the data before corticosteroid pulse therapy, all the data after the therapy showed significant improvement(P<0.05). Patients' vision at various times after the treatment improved gradually. The thickness of neuroepithelial layer of macular retina improved from(281±61)μm before treatment to(149±43)μm after treatment with significant difference(P=0.000). Flare examination result changed from 213.9±13.8 before treatment to 18.2±2.2 after treatment with significant difference(P=0.000).

    CONCLUSION:Microperimetry can reveal the changes in visual acuity and light sensitivity before and after the glucocorticoid pulse therapy in patients with acute pan-uveitis, which suggests that microperimetry can serve as an efficient way to observe the development of acute pan-uveitis and its therapeutic effects.

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李璇,刘茁.微视野在急性全葡萄膜炎激素冲击治疗前后的应用.国际眼科杂志, 2013,13(11):2273-2276.

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  • 收稿日期:2013-07-31
  • 最后修改日期:2013-10-16
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  • 在线发布日期: 2013-10-28
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