Liozon E, Vidal E, Liozon F
Service de médecine interne A, Centre hospitalier régional et universitaire, Hôpital Dupuytren, Limoges.
Rev Prat. 1999 Mar 15;49(6):605-8.
Ocular manifestations of giant cell arteritis, of which permanent amaurosis overshadows all others, occur still frequently. They are usually preceeded by the classical signs of temporal arteritis, which should allow an earlier diagnosis and prompt corticosteroid treatment. Indeed, corticosteroids have proved very effective in preventing ocular complications. Once permanent amauposis is present, the treatment is still urgent, in order to avoid the involvement of the other eye and to restore some vision of the affected eye. However, once the eye is damaged, there is little hope that corticosteroid treatment will improve the vision, depending essentially upon which delay it has been started. These fearsome ocular complications argue for a better knowledge of the suggestive signs of temporal arteritis and highlight the urgency of corticosteroid treatment.
巨细胞动脉炎的眼部表现仍然很常见,其中永久性黑矇比其他症状更为突出。这些眼部表现通常先于颞动脉炎的典型症状出现,而颞动脉炎的典型症状应能使疾病得到早期诊断并及时进行皮质类固醇治疗。事实上,皮质类固醇已被证明在预防眼部并发症方面非常有效。一旦出现永久性黑矇,治疗仍然刻不容缓,以避免另一只眼睛受累,并恢复患眼的部分视力。然而,一旦眼睛受损,皮质类固醇治疗改善视力的希望渺茫,这主要取决于开始治疗的延迟时间。这些可怕的眼部并发症表明需要更好地了解颞动脉炎的提示性体征,并凸显了皮质类固醇治疗的紧迫性。