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[糖皮质激素治疗与Fuchs异色性睫状体炎和特发性慢性前葡萄膜炎患者继发性眼压升高]

[Corticosteroid therapy and secondary elevated intraocular pressure in patients with Fuchs heterochromic cyclitis and idiopathic chronic anterior uveitis].

作者信息

Heinz C, Zureck-Imhoff B, Roesel M, Heiligenhaus A

机构信息

Augenabteilung, St. Franziskus Hospital, Münster, Germany.

出版信息

Klin Monbl Augenheilkd. 2010 May;227(5):413-7. doi: 10.1055/s-0028-1109885. Epub 2010 Mar 9.

DOI:10.1055/s-0028-1109885
PMID:20217637
Abstract

BACKGROUND

Due to different influences on anterior chamber angle structures, corticosteroids have a significant impact on secondary elevated intraocular pressure. This study examines the influence of corticosteroid therapy on the incidence of secondary elevated intraocular pressure in patients with Fuchs heterochromic cyclitis (FHC) and chronic anterior uveitis.

MATERIALS AND METHODS

Retrospective chart analyses of patients undergoing topical and systemic corticosteroid therapy were carried out.

RESULTS

Overall, data of 54 FHC and 49 CAU patients were analysed. Patients did not differ with respect to age, gender distribution and follow-up period. Seventeen (37 %) of the FHC patients and eight (18 %) of the CAU patients had secondary elevated intraocular pressure (p = 0.08). Number of months with topical therapy (54 vs. 20 months, p = 0.025) and number of months multiplicated with the frequency of topical maintenance therapy (158 vs. 61 p = 0.027) were significantly higher in the FHC patients. Only in the FHC group was an association with age (OR 1.16; 95 % CI 1.03 - 1.2; p = 0,006) and in the CAU group with the number of topical corticosteroid therapies (OR 1.15; 95 % CI 0.99 - 1.34; p = 0.03) evident in the multivariate analysis.

CONCLUSIONS

Pathomechanisms, resulting in secondary elevated intraocular pressure in patients with FHC and CAU, must be different as only in CAU patients was an association to corticosteroid therapy found.

摘要

背景

由于对前房角结构的影响不同,皮质类固醇对继发性眼压升高有显著影响。本研究探讨皮质类固醇治疗对富克斯异色性睫状体炎(FHC)和慢性前葡萄膜炎患者继发性眼压升高发生率的影响。

材料与方法

对接受局部和全身皮质类固醇治疗的患者进行回顾性病历分析。

结果

总体上,分析了54例FHC患者和49例CAU患者的数据。患者在年龄、性别分布和随访时间方面无差异。17例(37%)FHC患者和8例(18%)CAU患者出现继发性眼压升高(p = 0.08)。FHC患者的局部治疗月数(54个月对20个月,p = 0.025)以及局部维持治疗月数乘以频率(158对61,p = 0.027)显著更高。多因素分析显示,仅在FHC组中与年龄有关联(OR 1.16;95% CI 1.03 - 1.2;p = 0.006),在CAU组中与局部皮质类固醇治疗次数有关联(OR 1.15;95% CI 0.99 - 1.34;p = 0.03)。

结论

FHC和CAU患者导致继发性眼压升高的发病机制必然不同,因为仅在CAU患者中发现与皮质类固醇治疗有关联。

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