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葡萄膜炎与青光眼:发病机制与治疗的新见解

Uveitis and glaucoma: new insights in the pathogenesis and treatment.

作者信息

Sng Chelvin C A, Ang Marcus, Barton Keith

机构信息

Glaucoma Service, Moorfields Eye Hospital, London, UK; Department of Ophthalmology, National University Health System, Singapore, Singapore; Singapore Eye Research Institute, Singapore, Singapore.

Singapore Eye Research Institute, Singapore, Singapore; Singapore National Eye Centre, Singapore, Singapore.

出版信息

Prog Brain Res. 2015;221:243-69. doi: 10.1016/bs.pbr.2015.06.008. Epub 2015 Oct 1.

Abstract

Glaucoma is a potentially blinding complication of uveitis, where intraocular inflammation, secondary corticosteroid response, and varying types and degrees of angle abnormalities contribute to its pathogenesis. Management of uveitic glaucoma remains challenging. Treatment is targeted at reducing the inflammation and lowering the intraocular pressure. Recent studies have highlighted the role of viruses, such as cytomegalovirus, herpes simplex virus, and more recently Ebola virus, in the pathogenesis of uveitic glaucoma. Antiviral therapy may be beneficial in eyes with detectable viral DNA. The success of glaucoma surgery is decreased in eyes with uveitic glaucoma, and surgical interventions are associated with a higher incidence of postoperative complications. Novel glaucoma surgical and laser treatments may improve the predictability of surgery for uveitic glaucoma, but these require further evaluation.

摘要

青光眼是葡萄膜炎一种潜在致盲并发症,眼内炎症、继发性皮质类固醇反应以及不同类型和程度的房角异常均参与其发病机制。葡萄膜炎性青光眼的治疗仍然具有挑战性。治疗目标是减轻炎症和降低眼压。最近的研究强调了病毒,如巨细胞病毒、单纯疱疹病毒,以及最近的埃博拉病毒,在葡萄膜炎性青光眼发病机制中的作用。抗病毒治疗可能对检测到病毒DNA的眼睛有益。葡萄膜炎性青光眼患者的青光眼手术成功率降低,手术干预术后并发症发生率更高。新型青光眼手术和激光治疗可能会提高葡萄膜炎性青光眼手术的可预测性,但这些需要进一步评估。

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