Kovalev Iu N, Il'in I I
Vestn Oftalmol. 1990 Jul-Aug;106(4):65-9.
Clinical picture and course of eye involvement were studied in 254 patients with Reiter's disease. Altogether 130 patients suffered from conjunctivitis of varying severity, 23 from keratitis, 21 from episcleritis, 20 from uveitis, 2 from detachment of the retina, and 5 from secondary glaucoma. Chlamydia were detected in one third of conjunctivitis patients in scrapings off the conjunctiva. The eyes may be accidentally infected by agents from the urogenital organs if the patient does not observe the hygienic rules. Uveitis developed as a rule after a prolonged course of Reiter's disease. They were resistant to antichlamydial therapy because of autoimmune factors that underlay the condition pathogenesis. Deposits of immune complexes on antigens of ocular vascular coating were detected with the use of monospecific antiglobulin sera in 7 of 10 patients with active uveitis symptoms. The risk of Reiter's disease development in HLA B27 carriers is 27.17 times higher than the mean incidence of this disease in the population. HLA A9 and B40 antigen combinations occurred 7 times more often in uveitis patients than in reference subjects, A1 and B27 combinations were 4-5 times more incident.
对254例赖特综合征患者的眼部受累临床表现及病程进行了研究。共有130例患者患有不同程度的结膜炎,23例患有角膜炎,21例患有巩膜炎,20例患有葡萄膜炎,2例患有视网膜脱离,5例患有继发性青光眼。在三分之一的结膜炎患者结膜刮片中检测到衣原体。如果患者不遵守卫生规则,眼睛可能会意外感染来自泌尿生殖器官的病原体。葡萄膜炎通常在赖特综合征病程延长后发生。由于该病发病机制的自身免疫因素,它们对抗衣原体治疗有抗性。在10例有活动性葡萄膜炎症状的患者中,有7例使用单特异性抗球蛋白血清检测到免疫复合物沉积在眼部血管膜抗原上。HLA B27携带者发生赖特综合征的风险比该疾病在人群中的平均发病率高27.17倍。葡萄膜炎患者中HLA A9和B40抗原组合出现的频率比对照组高7倍,A1和B27组合出现的频率高4至5倍。