Tilganga Institute of Ophthalmology, Gaushala, Kathmandu, Nepal.
Curr Opin Ophthalmol. 2011 Nov;22(6):496-501. doi: 10.1097/ICU.0b013e32834bcbf4.
Seasonal hyperacute panuveitis (SHAPU), a mysterious disease of Nepal, has increased the burden of childhood blindness ever since it was described in 1975. Although moths are suspected as the cause, this source is not yet proven. The management of this disease is still not well outlined. This article reviews recent developments in the understanding of SHAPU pathogenesis, clinical features, cause, and preventive measures as well as curative management.
Smaller summer outbreaks occur every even year together with larger autumn outbreaks every odd year. Vitreous fluid from some cases grew bacteria on culture. Viruses were isolated in one case. Tiny hair follicles have been identified in ocular structures. Several cases had decreased corneal sensation and few cases had iris atrophy. Early vitrectomy is beneficial. Intravitreal vancomycin, amikacin, and dexamethasone injection have given good results. Unlike previous reports, the use of repeated subconjunctival dexamethasone injection was also claimed to reverse the eye disease. However, treatment helped to save the vision in one eye or both only if cases presented early enough (within 7 days) for treatment.
Recent findings have shown a correlation between SHAPU and moths (probably Gazalina); therefore, more research on this moth is urged. Various new findings also hint towards the involvement of microbes; thus, further advanced studies are required to confirm this involvement.
自 1975 年尼泊尔首次描述季节性超急性全葡萄膜炎（SHAPU）以来，这种神秘的疾病一直增加着儿童失明的负担。尽管蛾类被怀疑是病因，但这一来源尚未得到证实。目前对这种疾病的治疗方法仍未得到很好的阐述。本文综述了 SHAPU 的发病机制、临床特征、病因、预防措施以及治疗管理等方面的最新进展。
每隔一年夏季会有较小的暴发，每隔一年秋季会有较大的暴发。一些病例的玻璃体液在培养物中长出细菌。一例病例中分离出病毒。在眼部结构中发现了微小的毛囊。一些病例角膜感觉减退，少数病例虹膜萎缩。早期玻璃体切除术有益。玻璃体内万古霉素、阿米卡星和地塞米松注射已取得良好效果。与以往的报告不同，反复结膜下注射地塞米松也被认为可以逆转眼部疾病。然而，只有在足够早（治疗开始后 7 天内）就诊的情况下，治疗才能帮助挽救一只或两只眼睛的视力。
最近的发现表明 SHAPU 与蛾类（可能是 Gazalina）之间存在关联，因此需要对这种蛾类进行更多的研究。各种新发现也提示微生物的参与；因此，需要进一步的高级研究来证实这种参与。
