【摘要】 目的分析Vogt-小柳-原田综合征(VKH)急性葡萄膜炎期视网膜脱离与睫状体和前部脉络膜脱离程度的相关性。方法VKH10例20眼,荧光素眼底血管造影(FFA)的同时行超声生物显微镜(UBM)及光学相干断层成像术(OCT)检查,对UBM检查测量的睫状体和前部脉络膜脱离的高度与OCT测量的视网膜神经上皮脱离的高度进行相关性分析。结果FFA检查20眼均有多湖样视网膜脱离,UBM检查20眼均有睫状体和前部脉络膜脱离,脱离的高度均值为(185.2±209.0)μm,OCT检查显示视网膜神经上皮和色素上皮(RPE)脱离,脱离的高度为215~967μm,平均(557.07±268.96)μm。睫状体和前部脉络膜脱离与视网膜神经上皮脱离高度呈显著正相关(r=0.867,P=0.001)。结论VKH急性葡萄膜炎期脉络膜炎性渗出液向内通过受损的RPE蓄积在视网膜神经上皮下产生视网膜脱离,向外也可蓄积在脉络膜上腔并前行至睫状体上腔而产生睫状体脉络膜脱离,二者有明显相关性。更多还原

【Abstract】 ObjectiveAcute uveitis stage of Vogt-Koyanagi-Harada syndrome is misdiagnosed due to its similarity in clinical manifests with many fundus diseases.This clinical study was to investigate the correlation between retinal detachment and cyclodialysis,anterior choroidal detachment with acute uveitis stage of Vogt-Koyanagi-Harada syndrome.MethodsTotal of 10 cases(20 eyes)with Vogt-Koyanagi-Harada syndrome by clinical diagnosis were examined using fluorescine fundus angiography(FFA),ultrasound biomicoscopy(UBM) and optical coherence tomography(OCT) for a morphologic evaluation.ResultsMulti lake-like retinal detachment,cyclodialysis,anterior choroidal detachment was found in 20 eyes by FFA and UBM examination,and 18 eyes showed the incompletely choroidal detachment with the detachment height 90-150 μm,and 2 eyes shows the 360° complete choroidal detachment with the mean height (185.2±209.0)μm by UBM.The height of neurosensory detachment was (557.07±268.96) μm;the that of cyclodialysis and anterior choroidal detachment was (185.2±209.0) μm by OCT measurement.Neurosensory detachment was positively correlated with cyclodialysis and anterior choroidal detachment (γ=-0.867,P=0.001).ConclusionIn the acute uveitis phase of Vogt-Koyanagi-Harada syndrome,the choroidal exudation fluid accumulate under retinal neurosensory epithelium through impaired retinal pigmental epithelium and further result in retinal detachment,cyclodialysis and anterior choroidal detachment.Retinal detachment was correlative with cyclodialysis and anterior choroidal detachment.更多还原