Dordević-Jocić Jasmina, Zlatanović Gordana, Veselinović Dragan, Stanković-Babić Gordana, Vujanović Milena, Zivković Maja
Klinicki centar Nis, Nis.
Med Pregl. 2010 Sep-Oct;63(9-10):681-8. doi: 10.2298/mpns1010681d.
This study was aimed at providing an update on most recent developments regarding ocular and systemic manifestations and complications, clinical diagnosis and management, and molecular patophysiology of pseudoexfoliation syndrome.
Review of recent literature and own clinical and laboratory studies.
Pseudoexfoliation syndrome is an age-related disease in which abnormal fibrillar extracellular material is produced and accumulated in many ocular tissues. Recent progress and advances have led to improvements in clinical management by understanding the effects of the pseudoexfoliation process on the ocular tissues, by refining diagnostic criteria and applying new treatment regimes, and by developing preventive strategies to reduce surgical complications. Increasing evidence of systemic associations of cardiovascular, cerebrovascular, abdominal aorta aneurysm can provide better understanding and management of this condition, and new therapeutic goal. The current pathogenesis concept describes psuedoexfoliation syndrome as an elastic microfibrillopathy involving transforming growth factor-beta, matrix metalloproteinase oxidative stress.
Despite extensive research, the exact chemical composition of exfoliation material remains unknown. The presence of pseudoexfoliation should alert the physician to the increased risks of intraocular surgery, most commonly zonular dehiscence, capsular rupture, and vitreous loss during cataract extraction. Its associated clinical signs are important in the detection and management of glaucoma.
本研究旨在提供有关假性剥脱综合征的眼部和全身表现及并发症、临床诊断与管理以及分子病理生理学的最新进展。
回顾近期文献以及自身的临床和实验室研究。
假性剥脱综合征是一种与年龄相关的疾病,其中异常的纤维状细胞外物质在许多眼部组织中产生并积聚。近期的进展通过了解假性剥脱过程对眼部组织的影响、完善诊断标准和应用新的治疗方案以及制定预防策略以减少手术并发症,从而改善了临床管理。心血管、脑血管、腹主动脉瘤等全身关联的证据不断增加,有助于更好地理解和管理这种疾病,并确定新的治疗目标。目前的发病机制概念将假性剥脱综合征描述为一种涉及转化生长因子-β、基质金属蛋白酶氧化应激的弹性微纤维病。
尽管进行了广泛研究,但剥脱物质的确切化学成分仍不清楚。假性剥脱的存在应提醒医生注意眼内手术风险增加,最常见的是白内障摘除术中的悬韧带断裂、囊膜破裂和玻璃体丢失。其相关的临床体征在青光眼的检测和管理中很重要。