Наблюдение пациентки с острым некрозом сетчатки в течение длительного периода времени

Abstract

The medical and social significance of one of the most severe inflammatory diseases of the posterior segment of the eye, which includes acute retinal necrosis (ARN), is determined by the high degree of disability of patients. ARN occurs in somatically healthy people, but occurs more often among people suffering from immunosuppressive diseases or receiving immunosuppressive therapy. The diagnosis of ARN is made on the basis of clinical examination data according to the criteria developed in 1994 by the American Society of Uveitis Specialists. The prognosis of ARN is relatively unfavorable: the pathological process leads to practical blindness in 64 %, in 60 % there is a significant decrease in visual acuity. ARN is complicated by the development of retinal detachment in 65–75 %. Treatment of ARN includes intensive antiviral, anti-inflammatory, immunomodulatory therapy. Purpose: description of the observation of a patient with acute retinal necrosis over a long period of time. Material and methods. A long-term clinical observation of a patient with acute retinal necrosis for the period from 2008 to 2021 is presented. The patient underwent a standard ophthalmological examination, optical coherence tomography of the macular area, and ultrasound. Results. The development of ARN in the patient was observed after ARVI. Antiinflammatory treatment of ARN and surgical treatment of complications were carried out in the conditions of the academician S.N. Fyodorov Federal State Institution National Medical Research Center «Intersectoral Research and Technology Complex «Eye microsurgery» Ministry of Health of the Russian Federation», Novosibirsk Branch. The presented clinical case allows us to demonstrate the severe course of the pathological process and the development of serious complications. Timely conservative, laser and surgical treatment, active dynamic monitoring, despite the unfavorable prognosis for vision, made it possible to maintain residual vision in the patient. Conclusions. ARN is an important problem that requires further study and development of effective methods for early diagnosis, treatment and prevention of recurrence of this disease. Keywords: acute retinal necrosis; anti-inflammatory treatment