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[葡萄膜炎与多发性硬化症]

[Uvetitis and multiple sclerosis].

作者信息

Sisková A, Ríhová E, Havrdová E

机构信息

Ocní klinika 1, LF UK a VFN, Praha.

出版信息

Cesk Slov Oftalmol. 2005 Jul;61(4):235-44.

Abstract

AIM

To evaluate the type of uveitis, the time of the duration between the first ocular signs and establishing of the diagnosis of multiple sclerosis (MS), effect of the treatment, and the final visual acuity (VA).

METHODS

In a retrospective study, medical records of 41 patients (82 eyes) from the total of 1267 patients with uveitis treated at the Center for uveitis diagnosis and treatment at the Department of Ophthalmology of the Faculty Hospital and 1st Medical faculty, Charles University in Prague, Czech republic, during the period 1986-2003 were evaluated. The cohort consisted of 32 females and 9 males, mean age of 27 years (8-46 years). The mean follow-up period was 8 years (1-17 years).

RESULTS

The cohort consisted of 41 patients (82 eyes), 32 females and 9 males. The mean age at the beginning of the uveitis was 27 years, at the time of the diagnosis of the MS 29.5 years. In 19 patients the starting of the uveitis preceded the manifestation of the systemic disease. In 23 patients, the uveitis was the first manifestation of MS. The most common type of uveitis in patients with MS was the intermediate uveitis (IMU) and vasculitis of retinal vessels. In 82% of patients, we were able during the follow-up period to stabilize the VA, or even to improve it. The systemic immunosuppressive treatment was necessary in 83 % of patients.

SUMMARY

The MS was the second most common systemic disease in uveitis patients. It is necessary to follow-up young patients with unclear etiology of IMU or vasculitis, because the systemic disease may develop even few years after the first sings of uveitis. The collaboration between the neurologist and the ophthalmologist is of a great importance.

摘要

目的

评估葡萄膜炎的类型、首次眼部症状出现至多发性硬化症(MS)诊断确立之间的持续时间、治疗效果及最终视力(VA)。

方法

在一项回顾性研究中,对1986年至2003年期间在捷克共和国布拉格查理大学医学院第一附属医院眼科葡萄膜炎诊断与治疗中心接受治疗的1267例葡萄膜炎患者中的41例(82只眼)的病历进行了评估。该队列包括32名女性和9名男性,平均年龄27岁(8至46岁)。平均随访期为8年(1至17年)。

结果

该队列由41例患者(82只眼)组成,其中32例女性和9例男性。葡萄膜炎开始时的平均年龄为27岁,MS诊断时的平均年龄为29.5岁。19例患者葡萄膜炎的起始先于全身性疾病的表现。23例患者中,葡萄膜炎是MS的首发表现。MS患者中最常见的葡萄膜炎类型是中间葡萄膜炎(IMU)和视网膜血管炎。在82%的患者中,我们在随访期间能够稳定VA,甚至改善VA。83%的患者需要进行全身免疫抑制治疗。

总结

MS是葡萄膜炎患者中第二常见的全身性疾病。对于病因不明的IMU或血管炎的年轻患者,有必要进行随访,因为全身性疾病可能在葡萄膜炎首次出现症状后的数年甚至才会发生。神经科医生和眼科医生之间的合作非常重要。

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