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血清阴性脊柱关节病与眼睛

Seronegative spondyloarthropathies and the eye.

作者信息

Ali Amro, Samson C Michael

机构信息

New York Eye and Ear Infirmary, 310 East 14th Street, New York, NY, USA.

出版信息

Curr Opin Ophthalmol. 2007 Nov;18(6):476-80. doi: 10.1097/ICU.0b013e3282f0fda2.

Abstract

PURPOSE OF REVIEW

Ocular inflammation is a common and important manifestation of disease in patients with seronegative spondyloarthropathy.

RECENT FINDINGS

Anterior uveitis is among the most common manifestations of eye disease in patients with seronegative spondyloarthropathies. Additionally, a strong correlation exists among such affected patients and the presence of the HLA-B27 gene. Steroid treatment is often effective for uveitis associated with spondyloarthropathies. Patients with ocular inflammation that is chronic in nature or uncontrolled by steroid treatment have shown good response to immunosuppressive agents known to be effective for articular inflammation, such as methotrexate. Recent studies have shown the possible benefits of tumor necrosis factor-alpha inhibitors, such as infliximab and etanercept.

SUMMARY

Uveitis, a leading cause of blindness, is among the most common eye manifestations in patients affected by seronegative spondyloarthropathies. Evidence suggests both genetic and environmental factors in its pathogenesis. Immunomodulator treatments, including the recently popular biologics, may be effective in the control of chronic uveitis in patients with spondyloarthropathy. Ocular surgery is often needed in these patients, and appropriate cautions are required in order to achieve successful vision rehabilitation.

摘要

综述目的

眼部炎症是血清阴性脊柱关节病患者常见且重要的疾病表现。

最新发现

前葡萄膜炎是血清阴性脊柱关节病患者中最常见的眼部疾病表现之一。此外,此类患病患者与HLA - B27基因的存在之间存在强相关性。类固醇治疗通常对与脊柱关节病相关的葡萄膜炎有效。眼部炎症呈慢性或类固醇治疗无法控制的患者,对已知对关节炎症有效的免疫抑制剂,如甲氨蝶呤,有良好反应。最近的研究显示了肿瘤坏死因子 - α抑制剂,如英夫利昔单抗和依那西普,可能具有的益处。

总结

葡萄膜炎是失明的主要原因之一,是血清阴性脊柱关节病患者中最常见的眼部表现之一。有证据表明其发病机制涉及遗传和环境因素。免疫调节剂治疗,包括最近流行的生物制剂,可能对控制脊柱关节病患者的慢性葡萄膜炎有效。这些患者通常需要眼科手术,为实现成功的视力康复需要采取适当的预防措施。

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