[前葡萄膜炎的诊断与治疗分析]

Zheng Yue-zhong, Shi Ji-chuan

Tianjin Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China.

Zhonghua Yan Ke Za Zhi. 2010 Jan;46(1):25-8.

OBJECTIVE

To explore the clinical characters, effects of treatment, the prognosis of visual acuity and the problems in the treatment of the anterior uveitis.

METHODS

The retrospective case series study was used to observe the clinical characters and treatment effects of 478 cases of anterior uveitis from January 2001 to June 2007 in Tianjin Eye Hospital. Among the 478 cases of patients, the male was 281 cases and the female was 197 cases. The mean age was (36 +/- 15) years old. Both the clinical examinations and immunologic investigations were performed. The clinical characters, effects of treatment, complications and prognosis of the anterior uveitis were analyzed.

RESULTS

There were 242 cases (50.6%) with acute anterior uveitis, 197 cases (41.2%) with recurrent anterior uveitis and 39 cases (8.2%) with chronic anterior uveitis. There were 231 cases (48.3%) with idiopathic uveitis, 76 cases (15.9%) with human leukocyte antigen-B27 associated uveitis without systemic diseases, 52 cases (10.9%) with herpetic uveitis, 34 cases (7.1%) with ankylosing spondylitis, 29 cases (6.1%) with Fuchs syndrome, 24 cases (5.0%) with glaucomatocyclitic crisis and 17 cases (3.6%) with juvenile idiopathic arthritis-associated uveitis. The rate of complications was 31.6% (151 cases), the rate of mild visual impairment (less than 0.5) was 11.1% (53 cases), the moderate and severe visual impairment (less than 0.3) was 7.5% (36 cases), and the rates of blindness (less than 0.05) was 2.5% (12 cases).

CONCLUSIONS

The types of anterior uveitis are varied. Idiopathic anterior uveitis, human leukocyte antigen-B27 associated uveitis and herpetic uveitis are the most common entities. The careful clinical and immunologic examinations could be benefit for the etiological diagnosis and prompt treatment.

目的

探讨前葡萄膜炎的临床特征、治疗效果、视力预后及治疗中存在的问题。

方法

采用回顾性病例系列研究，观察2001年1月至2007年6月在天津眼科医院就诊的478例前葡萄膜炎患者的临床特征及治疗效果。478例患者中，男性281例，女性197例。平均年龄为（36±15）岁。进行了临床检查和免疫学检查。分析前葡萄膜炎的临床特征、治疗效果、并发症及预后。

结果

急性前葡萄膜炎242例（50.6%），复发性前葡萄膜炎197例（41.2%），慢性前葡萄膜炎39例（8.2%）。特发性葡萄膜炎231例（48.3%），无全身疾病的人类白细胞抗原B27相关性葡萄膜炎76例（15.9%），疱疹性葡萄膜炎52例（10.9%），强直性脊柱炎34例（7.1%），富克斯综合征29例（6.1%），青光眼睫状体炎危象24例（5.0%），幼年特发性关节炎相关性葡萄膜炎17例（3.6%）。并发症发生率为31.6%（151例），轻度视力损害（低于0.5）发生率为11.1%（53例），中度及重度视力损害（低于0.3）发生率为7.5%（36例）,失明率（低于0.05）为2.5%（12例）。