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[鸟枪弹样视网膜脉络膜病变]

[Birdshot retinochoroidopathy].

作者信息

Cassoux N, Lehoang P

机构信息

Service d'Ophtalmologie, Hôpital La Pitié, 75651 Paris Cedex 13.

出版信息

Ann Med Interne (Paris). 2000 May;151 Suppl 1:1S45-7.

Abstract

Birdshot retinochoriodopathy is a bilateral posterior uveitis seen in adults over 45 years of age. The uveitis is associated with moderate vitreal inflammation, vasculides of large vessels, chronic papillitis and the yellow birdshot spots typical of the disease. The disease shows tight linkages with HLA A29 carried by more than 90% of the patients. The visual prognosis depends on the development of complications of the chronic ocular inflammation, particularly crystoid macular edema. These complications lead to lowered visual acuity which becomes a major handicap. Long-term local or general corticosteroid therapy is required and leads to cortico-dependence. An immunosuppressor (cyclosporinA) may be associated. As these treatments cause major morbidity, intravenous immunoglobulins offer a less toxic therapeutic approach. Intravenous immunoglobulins can reduce inflammatory phenomena, providing an interesting alternative for the treatment of birdshot retinochoroidopathy.

摘要

鸟枪弹样视网膜脉络膜病变是一种发生于45岁以上成年人的双侧后葡萄膜炎。该葡萄膜炎伴有中度玻璃体炎症、大血管血管炎、慢性视乳头炎以及该病典型的黄色鸟枪弹样病灶。超过90%的患者携带与疾病紧密相关的HLA A29。视力预后取决于慢性眼部炎症并发症的发展,尤其是晶状体样黄斑水肿。这些并发症导致视力下降,成为主要障碍。需要长期局部或全身使用皮质类固醇治疗,且会导致皮质类固醇依赖。可能会联合使用免疫抑制剂(环孢素A)。由于这些治疗会引起严重的发病率,静脉注射免疫球蛋白提供了一种毒性较小的治疗方法。静脉注射免疫球蛋白可以减轻炎症现象,为鸟枪弹样视网膜脉络膜病变的治疗提供了一种有趣的替代方法。

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