Sivaraj R R, Durrani O M, Denniston A K, Murray P I, Gordon Caroline
Academic Unit of Ophthalmology, Division of Immunity and Infection, University of Birmingham, UK.
Rheumatology (Oxford). 2007 Dec;46(12):1757-62. doi: 10.1093/rheumatology/kem173. Epub 2007 Aug 5.
Ocular manifestations of lupus are fairly common, may be the presenting feature of the disease and can be sight-threatening. Almost any part of the eye and visual pathway can be affected by inflammatory or thrombotic processes. Ocular pain and visual impairment require urgent assessment by an ophthalmologist. Infection should be excluded. Optic neuritis and ischaemic optic neuropathy may be difficult to distinguish. Scleritis and severe retinopathy require systemic immunosuppression but episcleritis, anterior uveitis and dry eyes can usually be managed with local eye drops. Vaso-occlusive disease, particularly in the presence of antiphospholipid antibodies, requires treatment with anticoagulation and proliferative retinopathy is treated with laser therapy. Hydroxychloroquine rarely causes ocular toxicity at doses under 6.5 mg/kg/day. When this has occurred, it has been associated with more than 5 years of drug exposure.
狼疮的眼部表现相当常见，可能是该疾病的首发特征，且可能威胁视力。眼及视觉通路的几乎任何部位都可能受到炎症或血栓形成过程的影响。眼痛和视力损害需要眼科医生进行紧急评估。应排除感染。视神经炎和缺血性视神经病变可能难以区分。巩膜炎和严重视网膜病变需要全身免疫抑制治疗，但表层巩膜炎、前葡萄膜炎和干眼症通常可用局部滴眼液治疗。血管闭塞性疾病，尤其是在存在抗磷脂抗体的情况下，需要抗凝治疗，增生性视网膜病变则用激光治疗。羟氯喹在剂量低于6.5毫克/千克/天时很少引起眼部毒性。当发生这种情况时，通常与超过5年的药物暴露有关。
