Obuchowska Iwona, Mariak Zofia
Kliniki Okulistyki Akademii Medycznej w Białymstoku.
Klin Oczna. 2006;108(4-6):232-7.
Giant cell arteritis is a rare systemic vasculitis affecting large- and medium-sized arteries. Focal arteries lesions, include mononuclear cells infiltration of the vessel wall with giant cell formation. It is a disease of elderly persons and can result in a wide variety of systemic, neurological and ophthalmic complications, due to ischemia. The incidence of visual loss and ocular involvement varies between 14-88%, but one of the most common and severe complications is anterior ischemic optic neuropathy. The other ocular ischemic lesions include: central retinal artery occlusion, choroidal ischemia, diplopia, ocular motor paresis, anterior uveitis, cataract, ocular hypotony, corneal oedema and ulcerations, episcleritis and anterior scleritis, orbital cellulitis and pseudotumor. Because giant cell arteritis is potentially blinding disease, early diagnosis and immediate treatment with high dose corticosteroids may prevent further damage to the affected eye and prevent visual loss in the opposite eye. The purpose of this review is to revise established knowledge and to highlight the recent developments in diagnosis and management of giant cell arteritis.
巨细胞动脉炎是一种罕见的系统性血管炎,累及大中型动脉。局灶性动脉病变包括血管壁单核细胞浸润并形成巨细胞。这是一种老年人疾病,由于缺血可导致多种全身、神经和眼科并发症。视力丧失和眼部受累的发生率在14%至88%之间,但最常见和严重的并发症之一是前部缺血性视神经病变。其他眼部缺血性病变包括:视网膜中央动脉阻塞、脉络膜缺血、复视、眼肌麻痹、前葡萄膜炎、白内障、低眼压、角膜水肿和溃疡、表层巩膜炎和前巩膜炎、眼眶蜂窝织炎和假瘤。由于巨细胞动脉炎是一种潜在致盲性疾病,早期诊断并立即给予高剂量皮质类固醇治疗可防止患眼进一步受损,并预防对侧眼视力丧失。本综述的目的是修订已有的知识,并突出巨细胞动脉炎诊断和管理方面的最新进展。