Objective: To analyze the relationship between optical coherence tomography(OCT) performance and visual acuity of patients with acute retinal necrosis (ARN). Methods: Retrospective analysis was performed on the patients diagnosed with ARN at the ophthalmology department of Peking union hospital during October 2011 and May 2016. Fourteen patients (15 eyes), 9 males and 5 females, whose anterior and posterior inflammation disappeared and the retinal necrosis lesion in the fundus of the eye subsided were included. The mean age was (41.6±12.2) years. All patients underwent careful examinations including best corrected visual acuity (BCVA), slit-lamp microscope, indirect ophthalmoscope, color fundus picture, fundus fluorescein angiography (FFA) and OCT (results of their last consultations). Results: BCVA: 8 eyes were increased, 2 eyes were unchanged and 5 eyes were decreased at the last visit; light perception (LP) 1 eye, finger count (FC) 1 eye, 3 eyes of 0.01 to 0.1, 6 eyes of 0.15 to 0.25. The inflammatory reaction in the anterior segment of 14 eyes disappeared, while the inflammatory reaction of the remaining 1 eye was relieved. The fundus lesions of all 15 eyes disappeared. According to OCT results: five eyes (5/15) exhibited normal macula area, among the 5 eyes, 4 eyes are of 0.15 to 0.25 visual acuity, and 1 eye is of 0.5 visual acuity;macular epiretinal membrane is present in three eyes (3/15), of which the visual acuity is 0.02, 0.25 and 0.3 respectively macula edema is present in three eyes (3/15), among the 3 eyes, 1 eye (visual acuity of 0.01)showed thickening of neurosensory retina, cystoid change of fovea and several fluid dark areas, the other 2 eyes (visual acuity of 0.02 and 0.5 respectively) showed small diffuse fluid dark area in the neurosensory retina;atrophy of neurosensory retina and absence of IS/OS was found in four eyes (4/15), among the 4 eyes, the visual acuity of 3 is below 0.01, and the other 1 eye is of 0.08 visual acuity. Conclusions: The OCT performance of stationary phase of ARN tends to be positively correlated with the visual acuity of patients. The prognosis of visual acuity of the patients whose OCT results showed atrophy of neurosensory retina and absence of IS/OS is poor. (Chin J Ophthalmol, 2018, 54: 369-374).
目的： 探讨急性视网膜坏死（ARN）相干光层析成像术（OCT）黄斑区结构表现与视力的关系。 方法： 回顾性病例分析。收集2011年10月至2016年5月在北京协和医院眼科确诊为ARN且经治疗前后节炎性反应消失、眼底视网膜坏死灶消退的患者14例（15只眼），其中男性9例，女性5例，年龄（41.6±12.2）岁，平均随访时间7个月。所有患者均行OCT检查（选取末次随诊结果）、最佳矫正视力、裂隙灯眼前节检查、散大瞳孔后眼底检查、彩色眼底照相、荧光素眼底血管造影检查（FFA）。观察眼底病变OCT表现与视力预后的关系。 结果： 末次随访OCT显示黄斑区正常者5只眼（5/15），视力0.15~0.25者4只眼，0.5者1只眼。黄斑前膜3只眼（3/15），视力分别为0.02、0.25、0.3。黄斑区水肿3只眼（3/15），其中黄斑区神经上皮增厚，中央区囊样改变，可见数个大小不等的囊样暗区，中心凹陷隆起，外层组织光带层次不清，不完整1只眼，视力0.01；黄斑区视网膜神经上皮层间较小弥漫液性暗区，中心凹陷变平2只眼，视力分别为0.02、0.5。黄斑区视网膜神经上皮层萎缩变薄，椭圆体带消失4只眼（4/15），视力<0.01者3只眼，0.08者1只眼。最佳矫正视力提高者8只眼，不变者2只眼，下降者5只眼。其中无光感者1只眼，手动者1只眼，数指者1只眼，0.01~0.1者3只眼，0.15~0.25者6只眼，≥0.3者3只眼。14只眼前节炎性反应消失，1只眼前节炎性反应减轻。15只眼眼底病灶均消退，视网膜在位。 结论： ARN静止期的OCT表现多样，且与患者视力预后有相关趋势；OCT检查结果显示黄斑区视网膜神经上皮层萎缩变薄、椭圆体带消失者视力预后差。（中华眼科杂志，2018，54：369-374）.
Keywords: Retinal necrosis syndrome, acute; Tomography, optical coherence; Treatment outcome; Visual acuity.