摘要
目的:探讨Terson综合征的患者玻璃体与视网膜的病变发展与手术时机选择和疗效关系。方法:Terson综合征16例29眼,术前视力光感～0.02,病程2～9(平均4.1)mo。行玻璃体视网膜手术,术中根据玻璃体视网膜情况,采用眼内气体充填12眼,采用硅油充填17眼。结果:术中发现玻璃体出血大都集中在后极部;同时存在视网膜前出血10眼,且两眼基本对称,出血在黄斑区9眼,积血池可扩大到上下血管弓,并形成牵引的堤坝,多灶性出血4眼。首次术后29眼视力显著提高,无黄斑区视网膜前出血16眼视力提高到0.4～1.0(平均0.67);有黄斑区视网膜前出血9眼视力提高到0.1～0.5(平均0.36)。前者较后者术后视力显著提高(P<0.05)。术后随访25眼,约5～33(平均17.6)mo。术后发生视网膜脱离3眼,行巩膜外加压视网膜复位术,视网膜复位。结论:Terson综合征患者及时行玻璃体切割手术安全有效,伴有黄斑区视网膜前出血患者视力的恢复较差,说明黄斑区视网膜前出血对黄斑的视功能有损害。
AIM： To study the characteristic and therapeutic effects of vitreoretinal pathology in 16 Terson syndromes patients.
METHODS： 16 patients （29 eyes） with Terson syndrome were induded. The visual acuity varied from LP to 0.02, course of disease was 2-9mo （average 4.1 too）. All the patients received the vitrectomy. According to the status of the vitreous and retinal ,12 eyes were tempnaded with gas, 17eyes with silicon oil.
RESULTS. The vitreous hemorrhage was mostly centralized at the posterior area of the fundus, combined with the epiretinal hemorrhage in both eyes in the 10 eyes. The pool of hemorrhage extended to the arch of the vas- cular and formed tractive dyke. Multiple hemorrhage occurred in 4 eyes. After the first operation, the visual acuity improved in all 29 eyes, improved to 0.4-1.0 （averge 0.67） in 16 eyes without macular hemorrhage, and im-proved to 0.1-0.5 （average 0.36） in 9 eyes with macular hemorrhage. ~ CONCLUSION： Vitrectomy is an effective and safe treat- ment for Terson syndrome. Patients with epiretinal hem- orrhage in macular area have worst visual acuity, which indicate premacular hemorrhage is harmful to the function of macular.
出处
《国际眼科杂志》
CAS
2005年第6期1211-1213,共3页
International Eye Science
