Time Selection Of Vitrectomy For Acute Retinal Necrosis Syndrome Clinical Observation On The Effect Of Prognosis

Objective:To explore the influence of the timing of vitrectomy on the prognosis of patients with acute retinal necrosis syndrome(ARNS)during the course of treatment。 Methods:A systematic retrospective analysis of 22 patients(22 eyes)from the ophthalmic center of the second Hospital of Jilin University in January 2015 to November 2017 was performed,with an average age of 26-65 years,and 43.5±6.50 years old.It is divided into two groups.Group 1,15 cases with 15 eyes after treated by vitrectomy: Before operation,12 cases(12 eyes)with retinal detachment were identified,and the treatment of antiviral therapy was performed,and vitrectomy with silicone oil were managed,and after antiviral treatment,3 cases(3 eyes)of retinal detachment were admitted and underwent vitrectomy and silicone oil filling.Group 2(No retinal detacment peration Group): Systemic and ocular antiviral treatment after 3-6 weeks of necrosis is located in the vicinity of the equator,accompanied by light,moderate proliferative vitreous retinopathy(PVR),not yet retinal detachment 7 cases(7 eyes),row of pure vitrectomy 2 eyes,vitrectomy surgery with gas filling surgery 5 eyes.The two groups of visual acuity,intraocular pressure and retinal adhesion were statistically analyzed after operation.Results:After 3-28 months of follow-up,the group 1:15 vitrectomy and silicone oil filling surgery 2-6 months later,the vision was not significantly improved or even decreased,4 eyes after oil after the recurrence of retinal detachment,silicone oil has not been taken out.The visual acuity of 3 eyes(20%),the median preoperative visual acuity was hand movement(HM),and the median of postoperative visual acuity was finger counting(FC).Case Group 2: After vitrectomy,the retina of 7 eyes were flat,vision is improved than preoperative.Visual acuity was 7 eyes(100%),the median of preoperative visual acuity was finger counting,and the median postoperative vision was 0.15.In the case group,visual acuity of 2 eyes after vitrectomy was improve from the preoperative Fc/15 cm to the most recent 0.8 and the light sensation increased to the last 0.1.Conclusion:1.Early Anti-Virus,drug therapy for exudation and absorption can achieve better results for ARNS.2.Such as after antiviral treatment,necrosis foci spread to the equator near of retina with light and moderate PVR,vitrectomy can be effective to avoid retinal detachment,improve the prognosis of the disease.3.patients with ARNS after antiviral treatment discharged,should be timely follow-up,to avoid missed surgery time,resulting in retinal detachment and other serious consequences.