与系统性红斑狼疮相关的类Purtscher视网膜病变
Purtscher-like Retinopathy Associated with Systemic Lupus Erythematosus.
作者信息
Kunavisarut Paradee, Pathanapitoon Kessara, Rothova Aniki
机构信息
a Department of Ophthalmology , Faculty of Medicine, Chiang Mai University , Chiang Mai , Thailand and.
b Department of Ophthalmology , Erasmus Medical Center , Rotterdam , The Netherlands.
出版信息
Ocul Immunol Inflamm. 2016;24(1):60-8. doi: 10.3109/09273948.2014.932816. Epub 2014 Jul 14.
PURPOSE
To report on clinical manifestations of Purtscher-like retinopathy (PLR) associated with systemic lupus erythematosus (SLE) and visual outcomes.
METHODS
We performed a retrospective cohort study of 11 patients (21 affected eyes) with PLR in SLE.
RESULTS
All patients were treated with systemic corticosteroids ± immunosuppressive agents. Ocular therapy included intravitreal injections with bevacizumab in 18/21 eyes and posterior sub-Tenon injections with triamcinolone acetonide 13/21 eyes. Panretinal photocoagulation (PRP) was performed in 19/21 eyes and pars plana vitrectomy was required in 5/21 eyes. Visual improvement was found at follow-up of 3 and 6 months (p = 0.05). Poor visual outcome was associated with presence of neovascularizations at onset (p = 0.009), development of vitreous hemorrhage during PRP (p = 0.015), and active status of SLE after onset of PLR (p = 0.029).
CONCLUSIONS
PLR might manifest as a devastating complication of SLE. We recommend treating any systemic activity of SLE and starting an early ocular treatment.
目的
报告与系统性红斑狼疮（SLE）相关的普-罗二氏样视网膜病变（PLR）的临床表现及视力预后。
方法
我们对11例患有SLE相关PLR的患者（21只患眼）进行了一项回顾性队列研究。
结果
所有患者均接受全身用糖皮质激素±免疫抑制剂治疗。眼部治疗包括21只眼中的18只眼玻璃体内注射贝伐单抗，21只眼中的13只眼Tenon囊下注射曲安奈德。21只眼中的19只眼进行了全视网膜光凝（PRP），21只眼中的5只眼需要进行玻璃体切除术。在3个月和6个月的随访中发现视力有所改善（p = 0.05）。视力预后差与发病时存在新生血管（p = 0.009）、PRP期间发生玻璃体积血（p = 0.015）以及PLR发病后SLE的活动状态（p = 0.029）有关。
结论
PLR可能表现为SLE的一种严重并发症。我们建议治疗SLE的任何全身活动并尽早开始眼部治疗。
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