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目的探讨后葡萄膜炎患者并发黄斑囊样水肿(CME)的发生频率、临床表现和荧光素眼底血管造影(FFA)特征。方法自2002年7月至2005年6月,连续收集在我院行FFA检查的各类后葡萄膜炎患者67例106只眼,观察CME的临床表现、FFA特征和治疗效果。结果有18例患者28只眼(26.4%)出现CME改变。男7例,女11例,平均年龄(42.5±10.8)岁。FFA早期表现为黄斑区水肿遮挡脉络膜荧光而呈片状暗区,随之出现点片状渗漏,静脉期可见毛细血管扩张渗漏,后期可见荧光素蓄积在黄斑区各个小囊腔内,形成特有的花瓣状外观。18例患者分别给予糖皮质激素、非甾体抗炎药和碳酸酐酶抑制剂治疗后,黄斑水肿程度减轻,视力有不同程度改善。结论葡萄膜炎是一种严重影响视功能的眼病,其中CME明显致视力损害。早期发现和及时干预,可防止发生永久性视力损害。
Objective To investigate the frequency, clinical manifestations and fluorescein fundus angiography (FFA) characteristics of macular cystoid edema (CME) in patients with posterior uveitis. Methods From July 2002 to June 2005, 67 patients (106 eyes) of post-uveitis were collected continuously in our hospital. The clinical manifestations, FFA characteristics and therapeutic effect of CME were observed. RESULTS: CME changes occurred in 28 eyes (26.4%) of 18 patients. There were 7 males and 11 females with an average age of (42.5 ± 10.8) years. FFA macular edema showed early occlusion of choroidal fluorescence and flaky dark area, followed by punctate leakage, the venous phase can be seen leaking capillary expansion, late visible accumulation of fluorescein in the macular area of each small cyst cavity, the formation of Unique petal-like appearance. Eighteen patients were treated with glucocorticoids, NSAIDs and carbonic anhydrase inhibitors, respectively. The degree of macular edema and visual acuity were improved to some extent. Conclusion Uveitis is a serious ocular disease affecting visual function, in which CME is significantly impaired visual acuity. Early detection and timely intervention can prevent permanent visual impairment.