Department of Ophthalmology, Auckland District Health Board, Private Bag 92189, Auckland 1142, New Zealand.
Postgrad Med J. 2012 Dec;88(1046):713-8. doi: 10.1136/postgradmedj-2011-130282. Epub 2012 Sep 12.
Scleritis is a serious inflammatory condition that is often painful, and in severe cases can result in permanent loss of vision. Approximately half the patients affected have no identifiable cause, but 30%-40% have an underlying systemic autoimmune condition. Scleritis may be the initial manifestation of Wegener's granulomatosis or rheumatoid arthritis, and all patients with scleritis require a thorough systemic evaluation. Scleritis has a variable presentation and disease course, and may be an acute monophasic illness, a relapsing remitting process, or take a chronic course. Treatment options include local therapy with subconjunctival steroid injections for non-necrotising scleritis, and systemic anti-inflammatory or immunosuppressive therapy. Biologic agents have been used with success in some refractory cases. Ocular and systemic morbidity is reduced by timely treatment with immunosuppressant medications.
巩膜炎是一种严重的炎症性疾病，常伴有疼痛，在严重的情况下，可导致永久性视力丧失。约有一半的受影响患者无法确定病因，但 30%-40%的患者存在潜在的系统性自身免疫性疾病。巩膜炎可能是 Wegener 肉芽肿或类风湿关节炎的初始表现，所有巩膜炎患者都需要进行彻底的系统评估。巩膜炎的表现和病程各不相同，可能是急性单相疾病、复发性缓解过程，或呈慢性病程。治疗选择包括对非坏死性巩膜炎进行结膜下皮质类固醇注射的局部治疗，以及全身抗炎或免疫抑制治疗。生物制剂在一些难治性病例中已成功应用。及时使用免疫抑制剂治疗可降低眼部和全身的发病率。
