Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA.
Curr Opin Ophthalmol. 2010 Nov;21(6):463-7. doi: 10.1097/ICU.0b013e32833f1060.
To review new clinically relevant data regarding the cause and treatment of scleritis that has been identified over the past 36 months.
A recently described T-helper cell population, known as Th-17, has been implicated in scleritis. Large-scale, retrospective reviews of standard corticosteroid-sparing systemic therapies, published in the last few years, have demonstrated only moderate efficacy for any particular immunomodulatory agent, whereas new data have confirmed excellent efficacy and tolerability to subconjunctival corticosteroids.
Improved understanding of the immunopathophysiology of scleritis offers hope for future molecule-specific drug design. Data continue to support the use of local steroids as a reasonable therapeutic option for nonnecrotizing, noninfectious anterior scleritis.
回顾过去 36 个月中发现的与巩膜炎病因和治疗相关的新的临床相关数据。
最近描述的一种辅助性 T 细胞群,称为 Th17,与巩膜炎有关。过去几年发表的关于标准皮质类固醇类药物免疫抑制疗法的大型回顾性研究表明,任何特定的免疫调节剂的疗效仅为中等,而新的数据证实了眼周皮质类固醇的优异疗效和耐受性。
对巩膜炎的免疫病理生理学的深入了解为未来的分子特异性药物设计带来了希望。数据继续支持局部类固醇作为非坏死性、非传染性前巩膜炎的合理治疗选择。