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眼型 Behçet 病的治疗。

Therapy of ocular Behçet disease.

机构信息

Centre of Ophthalmology, University of Tuebingen , Tuebingen , Germany .

出版信息

Ocul Immunol Inflamm. 2014 Feb;22(1):64-76. doi: 10.3109/09273948.2013.866257. Epub 2013 Dec 30.

Abstract

Ocular involvement in Behçet disease (BD) is characterized by recurrent inflammatory attacks and spontaneous resolution of acute inflammatory signs. Both frequency and severity of uveitis attacks determine the magnitude of irreversible damage to intraocular structures and long-term visual prognosis. Recurrent attacks of occlusive retinal vasculitis lead to vision-threatening complications such as cystoid macular edema, retinal neovascularization, optic atrophy and retinal atrophy. This manuscript updates about the role of various drugs in the management of BD, discussing corticosteroids, disease modifying immunosuppressive drugs, and finally biologicals (anti-TNF-blocking agents and alpha interferon) which seem to be superior compared to all other available drugs in preventing loss of vision. Also recent findings from new biologicals will be summarized, and especially the role of these drugs in children will be discussed in detail. The authors suggest that at least moderate to severe retinal involvement should become treated with biologicals whenever available.

摘要

贝赫切特病(BD)的眼部受累表现为反复发作的炎症性攻击和急性炎症征象的自发消退。葡萄膜炎发作的频率和严重程度决定了眼内结构不可逆损伤的程度和长期的视觉预后。复发性闭塞性视网膜血管炎导致威胁视力的并发症,如囊样黄斑水肿、视网膜新生血管、视神经萎缩和视网膜萎缩。本文更新了各种药物在 BD 治疗中的作用,讨论了皮质类固醇、改变疾病的免疫抑制剂,以及生物制剂(抗 TNF 阻断剂和α干扰素),这些药物在预防视力丧失方面似乎优于所有其他可用药物。还总结了来自新型生物制剂的最新发现,并详细讨论了这些药物在儿童中的作用。作者建议,只要有生物制剂可用,就应该对至少中度至重度视网膜受累进行治疗。

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