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[经组织学证实的系统性结节病患者眼部结节病的临床病程]

[Clinical course of ocular sarcoidosis in patients with histologically proven systemic sarcoidosis].

作者信息

Kirsch O, Frau E, Nodarian M, Labetoulle M, Offret H

机构信息

Service d'Ophtalmologie, Centre Hospitalo-Universitaire du Kremlin Bicêtre, 78 Avenue du Général Leclerc, 94270 Kremlin Bicêtre, France.

出版信息

J Fr Ophtalmol. 2001 Jun;24(6):623-7.

Abstract

PURPOSE

We reviewed the clinical features, natural history and visual prognosis of 9 patients with histologically confirmed ocular and systemic sarcoidosis.

PATIENTS

Nine patients underwent a follow-up study between 1993 and 1998. The diagnosis of sarcoidosis was supported by histological evidence of non caseating epithelioid-cell granuloma in tissue biopsy.

RESULTS

The mean age was 40.912 years. The mean follow-up was 22.7 months (range 6 - 54 months). The ophthalmic involvement was bilateral in 8 patients. Before treatment, 3 eyes (17.6%) had a visual acuity less than 1/10. Two eyes (11.7%) had a visual acuity less than 3/10 and 10 eyes (58.8%) more than 6/10. The anterior uveitis was granulomatous in 2 eyes (11.7%) and non granulomatous in 8 eyes (47%). Five eyes (29.4%) had a pars planitis. The posterior segment manifestations of sarcoidosis were retinal vasculitis in 7 eyes (41.1%), papillitis in 10 eyes (58.8%) and choroidal granulomas in 2 eyes (11.7%). Seven patients were treated with systemic corticosteroids. One patient was treated with steroid eye-drops. After treatment, one eye (5.8%) had a visual acuity less than 1/10 and 13 eyes more than 6/10. After treatment, the choroidal granulomas disappeared and the intra-ocular inflammation was controlled in all cases.

CONCLUSION

Although the number of patients in our series is small, the prognosis for ocular sarcoidosis appears to be good.

摘要

目的

我们回顾了9例经组织学确诊的眼部和全身性结节病患者的临床特征、自然病程及视力预后情况。

患者

9例患者于1993年至1998年接受了随访研究。结节病的诊断得到了组织活检中非干酪样上皮样细胞肉芽肿的组织学证据支持。

结果

平均年龄为40.912岁。平均随访时间为22.7个月(范围6 - 54个月)。8例患者的眼部受累为双侧性。治疗前,3只眼(17.6%)视力低于1/10。2只眼(11.7%)视力低于3/10,10只眼(58.8%)视力高于6/10。2只眼(11.7%)前葡萄膜炎为肉芽肿性,8只眼(47%)为非肉芽肿性。5只眼(29.4%)有周边部葡萄膜炎。结节病的后段表现为7只眼(41.1%)视网膜血管炎,10只眼(58.8%)视乳头炎,2只眼(11.7%)脉络膜肉芽肿。7例患者接受了全身皮质类固醇治疗。1例患者接受了类固醇眼药水治疗。治疗后,1只眼(5.8%)视力低于1/10,13只眼视力高于6/10。治疗后,脉络膜肉芽肿消失,所有病例的眼内炎症均得到控制。

结论

尽管我们系列研究中的患者数量较少,但眼部结节病的预后似乎良好。

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