摘要
急性视网膜坏死综合征(ARN)是由疱疹病毒感染引起的一种进展迅速、致盲性强的眼部疾病。本病起病急、发展快,若未能及时诊治,常因出现孔源性视网膜脱离、视神经萎缩、顽固性低眼压等严重并发症,或累及对侧眼,导致患者视功能遭受不可逆损害。ARN在临床上较为少见,眼科医师普遍对其诊断经验有限;加之治疗方案相对复杂,涵盖抗病毒药物、糖皮质激素应用及玻璃体切割手术等多方面因素,目前国内各级医院在诊疗过程中仍多以自身经验为基础,缺乏统一规范。为提升ARN的诊疗规范化水平,中华医学会眼科学分会眼底病学组与中国医师协会眼科医师分会眼底病专业委员会共同牵头,在全面检索和评估国内外相关文献、综合分析最新临床研究进展的基础上,结合我国社会经济发展现状,组织制定了《急性视网膜坏死综合征诊断和治疗专家共识》。本共识经过多轮核心专家及讨论专家审议与修订,最终定稿。内容涵盖ARN的临床表现、影像学与病原学检查、诊断与鉴别诊断、药物治疗及手术治疗等方面,旨在为眼科专科医师和全科医师提供系统、清晰的临床实践参考。本共识坚持以循证医学为依据,兼顾我国实际医疗条件与诊疗需求,对ARN的临床诊治提出原则性指导。所推荐的诊疗路径适用于大多数患者,但临床医师在具体应用时,仍应综合考虑患者病情、治疗意愿、经济条件等个体差异,灵活制定诊治方案。
Acute Retinal Necrosis Syndrome(ARN)is a severe,vision-threatening ocular disease caused by herpesvirus infections.It is characterized by abrupt onset and rapid progression,often leading to irreversible visual impairment due to complications in the affected eye such as rhegmatogenous retinal detachment,optic atrophy,and intractable hypotony,and potential involvement of the fellow eye if not promptly diagnosed and treated.As ARN is relatively uncommon,many ophthalmologists lack sufficient experience in diagnosing ARN.In addition,its management is complex,typically involving antiviral therapy,corticosteroids,and vitrectomy.Currently,diagnostic and therapeutic approaches to ARN in hospitals across China are largely based on individual clinical experience,underscoring the urgent need for a standardized clinical protocol.To address this,the Fundus Diseases Group in Ophthalmology Branch of Chinese Medical Association and the Professional Committee of Fundus Diseases in Ophthalmology Branch of Chinese Medical Doctor Association have jointly developed Expert consensus on the diagnosis and treatment of acute retinal necrosis syndrome.The consensus is informed by a comprehensive review of the literature,the latest clinical research findings,and consideration of the current socio-economic context in China.Following multiple rounds of expert review and revision,the final version has been completed.This document provides a detailed account of ARN,covering clinical manifestations,imaging and etiological assessments,diagnostic and differential diagnostic criteria,as well as medical and surgical treatment strategies.It is intended to serve as a practical guide for both subspecialized and general ophthalmologists.Developed in accordance with the principles of evidence-based medicine and adapted to China’s clinical realities,the consensus offers practical guidance for the diagnosis and management of ARN.While the proposed clinical pathway is designed to meet the needs of most patients,clinicians are encouraged to tailor treatment plans based on individual patient factors,including disease severity,therapeutic options,and economic considerations.
作者
中华医学会眼科学分会眼底病学组
中国医师协会眼科医师分会眼底病专业委员会
徐格致
黎晓新
许迅
Fundus Diseases Group in Ophthalmology Branch of Chinese Medical Association;Professional Committee of Fundus Diseases in Ophthalmology Branch of Chinese Medical Doctor Association;Xu Gezhi;Li Xiaoxin;Xu Xun
出处
《中华眼底病杂志》
北大核心
2025年第11期821-840,共20页
Chinese Journal of Ocular Fundus Diseases
关键词
急性视网膜坏死综合征
诊断
治疗
诊疗规范
专家共识
Acute retinal necrosis syndrome
Diagnosis
Treatment
Diagnosis and treatment norms
Expert consensus
