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[炎症性脉络膜新生血管]

[Inflammatory choroidal neovascularisations].

作者信息

Winterhalter S, Joussen A M, Pleyer U, Stübiger N

机构信息

Klinik für Augenheilkunde, Charité Universitätsmedizin Berlin.

出版信息

Klin Monbl Augenheilkd. 2012 Sep;229(9):897-904. doi: 10.1055/s-0032-1315249. Epub 2012 Sep 12.

Abstract

Inflammation plays a key role in the induction of choroidal neovascular membranes (CNV). This explains why each form of posterior uveitis may lead to CNV formation. Diseases like presumed ocular histoplasmosis syndrome (POHS), multifocal choroiditis (MFC) or punctate inner choroidopathy (PIC) carry a high risk of CNV creation. Inflammatory processes mostly cause classical membranes. Because of the classical membrane form, smaller membrane size and the younger age of the patients' inflammatory membranes are often better treatable than membranes in AMD patients. In the times before VEGF inhibition inflammatory membranes were treated with argon laser coagulation and later with PDT. Nowadays better visual acuity results are achievable through VEGF inhibitor injections with or without PDT. This is proven by a few publications with greater numbers of patients because of the rarity of the diseases and several case reports in the literature. In addition to CNV treatment the control of intraocular inflammation should never be forgotten because it forms the leading CNV trigger.

摘要

炎症在脉络膜新生血管膜(CNV)的诱导中起关键作用。这就解释了为什么每种形式的后葡萄膜炎都可能导致CNV形成。像推测性眼组织胞浆菌病综合征(POHS)、多灶性脉络膜炎(MFC)或点状内层脉络膜病变(PIC)等疾病具有较高的CNV形成风险。炎症过程大多导致典型的新生血管膜。由于典型的膜形式、较小的膜尺寸以及患者炎症性新生血管膜的年龄较轻,这些膜通常比AMD患者的新生血管膜更易于治疗。在VEGF抑制治疗出现之前,炎症性新生血管膜采用氩激光凝固治疗,后来采用光动力疗法(PDT)治疗。如今,通过注射VEGF抑制剂(无论是否联合PDT)可获得更好的视力结果。由于这些疾病罕见,少数大量患者的出版物以及文献中的几例病例报告证明了这一点。除了CNV治疗外,绝不应忘记控制眼内炎症,因为它是主要的CNV触发因素。

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