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了解葡萄膜炎:研究对视力结果的影响。

Understanding uveitis: the impact of research on visual outcomes.

机构信息

Retina and Inflammation, Centers for Specialized Ophthalmology, Lausanne, Switzerland.

出版信息

Prog Retin Eye Res. 2011 Nov;30(6):452-70. doi: 10.1016/j.preteyeres.2011.06.005. Epub 2011 Jul 22.

Abstract

The term uveitis encompasses a very diverse group of inflammatory ocular diseases that cause a significant burden of legal and economic blindness. Indeed, the socioeconomic impact of uveitis is at least as significant as that of diabetic retinopathy and, in the majority of cases, those affected are young individuals of working age. Significant progress has been made in our understanding of the mechanisms underlying the inflammatory process through the use of animal models, but correlation with human disease has proved elusive and many scientific approaches which appear highly effective in animal models prove to be less effective in patients. Nevertheless, effective, targeted treatments are needed in uveitis as current treatment is based on corticosteroids and immunosuppressive drugs whose usefulness is limited by their many side-effects. The aims of this review are to summarize the state of clinical research in uveitis, to identify gaps in our knowledge, and to propose new opportunities and methodologies for future developments in all aspects of uveitis research, including epidemiology, economic impact analysis, diagnosis, therapeutics, and clinical study design. Optimal patient management and efficient drug development depend on validated structured tools, such as those that have helped to drive a rapid acceleration in the means and methods available to assess and treat patients with rheumatoid arthritis and cancer. Uveitis care should witness a similar boom as the issues discussed are resolved.

摘要

葡萄膜炎是一组非常多样化的炎症性眼病,会导致相当大的法律和经济失明负担。事实上,葡萄膜炎的社会经济影响至少与糖尿病视网膜病变一样大,而且在大多数情况下,受影响的是处于工作年龄的年轻人。通过使用动物模型,我们在理解炎症过程的机制方面取得了重大进展,但与人类疾病的相关性一直难以捉摸,许多在动物模型中看起来非常有效的科学方法在患者中效果较差。然而,葡萄膜炎需要有效的靶向治疗,因为目前的治疗方法基于皮质类固醇和免疫抑制剂,其用途受到其许多副作用的限制。本综述的目的是总结葡萄膜炎临床研究的现状,确定我们知识中的差距,并为葡萄膜炎研究的各个方面提出新的机会和方法,包括流行病学、经济影响分析、诊断、治疗和临床研究设计。优化患者管理和药物开发取决于经过验证的结构化工具,这些工具帮助推动了评估和治疗类风湿关节炎和癌症患者的手段和方法的快速发展。随着所讨论问题的解决,葡萄膜炎护理应该会迎来类似的繁荣。

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