Lai Frank H P, Liu David T L, Lam Dennis S C
From the Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, The People's Republic of China.
Asia Pac J Ophthalmol (Phila). 2013 Nov-Dec;2(6):375-87. doi: 10.1097/APO.0b013e3182a2c90b.
The purpose of this article is to highlight evidence about the medical and surgical management of intermediate uveitis (IU). Updated understandings of the immunopathology of IU were reviewed in this retrospective literature review. Literature selection for this review was based on the PubMed database (National Library of Medicine) and OVID database (Wolters Kluwer). Articles deemed relevant were selected and highlighted. Intermediate uveitis is most often a benign form of uveitis. Since intermediate uveitis has been described in association with different systemic disorders, the initial diagnostic evaluation should serve to exclude masquerade syndromes and infectious diseases in which immunosuppression may be ineffective or contraindicated. Although the pathogenesis of intermediate uveitis is not fully understood, identification of proinflammatory molecules involved in the IU has contributed to the development and implementation of new therapies. Studies about the use of various immunosuppressants, biological agents and surgical treatment on IU have provided more evidence for managing IU. Nevertheless, corticosteroids remain the mainstay of treatment. The treatment options of intermediate uveitis are evolving, with the development of various immunosuppressants and biological agents. The management of intermediate uveitis should be tailored individually, based on specific causes of the disease and associated complications.
本文旨在强调关于中间葡萄膜炎（IU）药物及手术治疗的证据。在本次回顾性文献综述中，对IU免疫病理学的最新认识进行了回顾。本综述的文献选取基于美国国立医学图书馆的PubMed数据库和威科集团的OVID数据库。选取并突出显示了被认为相关的文章。中间葡萄膜炎通常是葡萄膜炎的一种良性形式。由于中间葡萄膜炎已被描述与不同的全身性疾病相关，初始诊断评估应有助于排除伪装综合征和免疫抑制可能无效或禁忌的感染性疾病。尽管中间葡萄膜炎的发病机制尚未完全明确，但对参与IU的促炎分子的识别有助于新疗法的开发和应用。关于各种免疫抑制剂、生物制剂及手术治疗用于IU的研究为IU的管理提供了更多证据。然而，皮质类固醇仍然是主要治疗手段。随着各种免疫抑制剂和生物制剂的发展，中间葡萄膜炎的治疗选择也在不断演变。中间葡萄膜炎的管理应根据疾病的具体病因和相关并发症进行个体化调整。
