[Toxoplasmic chorioretinitis complicated by retinal detachment].
[Toxoplasmic chorioretinitis complicated by retinal detachment].
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弓形虫性脉络膜视网膜炎并发视网膜脱离[J].
DOI：
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发表时间：
1997
期刊：
影响因子：
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通讯作者：
H. Offret
中科院分区：
文献类型：
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作者：
E. Frau;N. Grégoire;M. Lautier;M. Labetoulle;P. Lehoang;H. Offret
目的
描述和分析脉络膜视网膜弓形虫病与视网膜脱离的关系。
患者和方法
1992年11月至1996年3月，7名免疫功能正常的患者接受了眼弓形体视网膜脉络膜炎和视网膜脱离的检查和治疗。
结果
7例患者中，5例为活动性视网膜脉络膜炎，2例为典型的非活动性瘢痕。活动期视网膜裂孔3例，视网膜后部裂孔1例，萎缩性瘢痕边缘裂孔1例。非活动性视网膜病变1例为牵拉性视网膜脱离，1例为完全性视网膜脱离、多处撕裂和PVR。5例患者在转诊前接受了皮质类固醇治疗，但没有使用抗弓形虫药物。7例患者接受了硅油或长时间丙交酯气体填充的眼内手术。3名患者发生PVR和视网膜再脱离，2名患者接受了进一步手术。6例获得良好的解剖效果。
结论
与弓形虫性视网膜脉络膜炎相关的视网膜脱离是罕见的。然而，这是一个严重的复杂问题。使用类固醇来挽救视力可能会恶化临床病程，这可能是合理的，以减少对弓形虫抗原的过敏反应，但它们应该与抗菌药物联合使用。
PURPOSE
To describe and analyse relationship between chorioretinal toxoplasmosis and retinal detachment.
PATIENTS AND METHODS
Seven immunocompetent patients examined and treated between November 1992 and March 1996, with ocular toxoplasmic retinochoroiditis and retinal detachment.
RESULTS
Of the 7 patients examined, 5 had active retinochoroiditis and 2 had typical inactive scars. Of the patients with active focus 3 had giant retinal tears, one had a posterior retinal tear and one had a retinal tear located at the edge of an atrophic scar. Of the patients with inactive lesions, one had tractional retinal detachment and the other presented with a complete retinal detachment, multiples tears and PVR. Five patients were treated by corticosteroid without antitoxoplasmic drug before they were referred. The seven patients underwent endo-ocular surgery with silicon oil or long actic gas tamponade. Three patients developed PVR and redetachment of the retina and two patients underwent further surgery. Good anatomical result was obtained in 6 patients.
CONCLUSION
Retinal detachment associated with toxoplasmic retinochoroiditis is rare. However it represents a serious complication. Steroid administrated to salvage vision may then worsen the clinical course, these may be justified to reduce hypersensitivity to toxoplasma antigen, but they should be combined with an antimicrobial agent.