Department of Ophthalmology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Cleve Clin J Med. 2012 Nov;79 Suppl 3:S31-3. doi: 10.3949/ccjm.79.s3.07.
Ophthalmic manifestations of vasculitis can be orbital, ocular (affecting the globe), or intraocular. Orbital inflammation manifests as sudden onset of pain, erythema, and proptosis, and can be sight-threatening. In the globe, red eye is typical in both episcleritis and scleritis. Episcleritis is usually otherwise asymptomatic with blanching upon instillation of topical phenylephrine, whereas scleritis is painful and does not blanch. Infectious and rheumatic diseases are present in nearly 50% of patients with scleritis. The symptoms of keratitis are similar to those of scleritis; superficial keratitis is benign but peripheral ulcerative keratitis can be sight-threatening. Anterior uveitis is the most frequent ocular manifestation of Behçet disease. Approximately 30% of patients with granulomatosis with polyangiitis (Wegener's granulomatosis) have ocular involvement, with orbital disease being most common. With ophthalmic manifestations of vasculitis, tissue biopsy of any site that is amenable to biopsy is recommended. Biopsy must be interpreted within the context of treatment.
血管炎的眼部表现可以是眼眶、眼部（影响眼球）或眼内。眼眶炎症表现为疼痛、红斑和眼球突出，可能危及视力。在眼球中，巩膜炎和表层巩膜炎都会出现眼红。表层巩膜炎通常无症状，局部应用苯肾上腺素后变白，而巩膜炎则疼痛且不会变白。感染性和风湿性疾病在近 50%的巩膜炎患者中存在。角膜炎的症状与巩膜炎相似；浅层角膜炎是良性的，但周边溃疡性角膜炎可能危及视力。前葡萄膜炎是 Behçet 病最常见的眼部表现。约 30%的肉芽肿性多血管炎（韦格纳肉芽肿）患者有眼部受累，最常见的是眼眶疾病。对于有血管炎眼部表现的患者，建议对任何可进行活检的部位进行组织活检。活检必须在治疗的背景下进行解释。
