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全身性炎症性疾病中的眼睛。

The eye in systemic inflammatory diseases.

作者信息

McCluskey Peter, Powell Richard J

机构信息

Department of Ophthalmology at St Vincent's Hospital and Royal Prince Alfred Hospital, Sydney, Australia.

出版信息

Lancet. 2004;364(9451):2125-33. doi: 10.1016/S0140-6736(04)17554-5.

Abstract

Systemic inflammatory diseases commonly affect the sclera, cornea, retina, and orbit, and can pose a serious threat to sight. They encompass both primary and secondary vasculitic disorders and specific granulomatous inflammatory conditions. As well as direct eye involvement from the systemic inflammatory process, there can be signs of ocular ischaemia due to carotid or ophthalmic arteritis, hypertensive retinopathy, and ocular complications such as chloroquine maculopathy related to anti-inflammatory drug treatment. Additionally, systemic infection relating to the eye, either as the result of primary infective disease processes or infection secondary to immunosuppression, might be mistaken as endogenous intraocular inflammation. Infection can closely mimic the ocular signs of endogenous inflammation, and in selected patients (such as those who have been immunosuppressed to treat vasculitis and who additionally have had invasive surgery, indwelling intravenous catheters, or systemic sepsis), it might be necessary to specifically exclude infection by the sampling and culturing of intraocular fluids and tissue.

摘要

全身性炎症性疾病通常会影响巩膜、角膜、视网膜和眼眶,并可能对视力构成严重威胁。它们包括原发性和继发性血管炎疾病以及特定的肉芽肿性炎症性疾病。除了全身性炎症过程直接累及眼部外,还可能出现由于颈动脉或眼动脉炎、高血压性视网膜病变以及与抗炎药物治疗相关的眼部并发症(如氯喹黄斑病变)导致的眼部缺血迹象。此外,与眼睛相关的全身性感染,无论是原发性感染性疾病过程的结果还是免疫抑制继发的感染,都可能被误诊为内源性眼内炎症。感染可能与内源性炎症的眼部体征极为相似,对于某些特定患者(如那些为治疗血管炎而接受免疫抑制治疗且还进行了侵入性手术、留置静脉导管或发生全身性脓毒症的患者),可能有必要通过采集眼内液体和组织进行采样和培养来明确排除感染。

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