Rosenbaum James T, Sibley Cailin H, Lin Phoebe
aDepartment of Ophthalmology, Casey Eye Institute, Oregon Health & Sciences University bDepartment of Medicine, Oregon Health & Sciences University cDepartment of Cell Biology, Oregon Health & Sciences University, Portland, Oregon, USA dLegacy Devers Eye Institute, Legacy Health System, Portland, Oregon, USA.
Curr Opin Rheumatol. 2016 May;28(3):228-35. doi: 10.1097/BOR.0000000000000271.
Ophthalmologists and rheumatologists frequently have a miscommunication among themselves, and as a result differ in their opinion for patients consulting them with retinal vasculitis. This report seeks to establish a common understanding of the term, retinal vasculitis, and to review recent studies on this diagnosis.
The genetic basis of some rare forms of retinal vascular disease has recently been described. Identified genes include CAPN5, TREX1, and TNFAIP3; Behçet's disease is a systemic illness that is very commonly associated with occlusive retinal vasculitis; retinal imaging, including fluorescein angiography and other newer imaging modalities, has proven crucial to the identification and characterization of retinal vasculitis and its complications; although monoclonal antibodies to interleukin-17A or interleukin-1 beta failed in trials for Behçet's disease, antibodies to TNF-alpha, either infliximab or adalimumab, have demonstrated consistent benefit in managing this disease. Interferon treatment and B-cell depletion therapy via rituximab may be beneficial in certain types of retinal vasculitis.
Retinal vasculitis is an important entity for rheumatologists to understand. Retinal vasculitis associated with Behçet's disease responds to monoclonal antibodies that neutralize TNF, but the many other forms of noninfectious retinal vasculitis may require alternate therapeutic management.
眼科医生和风湿病学家之间经常存在沟通不畅的情况，因此在为患有视网膜血管炎的患者提供咨询时，他们的意见存在差异。本报告旨在对视网膜血管炎这一术语达成共识，并回顾有关该诊断的最新研究。
最近已描述了一些罕见形式的视网膜血管疾病的遗传基础。已确定的基因包括钙蛋白酶5、三磷酸核苷外切酶1和肿瘤坏死因子α诱导蛋白3；白塞病是一种全身性疾病，常与闭塞性视网膜血管炎相关；视网膜成像，包括荧光素血管造影和其他更新的成像方式，已被证明对视网膜血管炎及其并发症的识别和特征描述至关重要；尽管抗白细胞介素-17A或抗白细胞介素-1β单克隆抗体在白塞病试验中失败，但抗肿瘤坏死因子-α单克隆抗体，即英夫利昔单抗或阿达木单抗，在治疗该疾病方面已显示出持续的疗效。干扰素治疗和通过利妥昔单抗进行的B细胞清除疗法可能对某些类型的视网膜血管炎有益。
视网膜血管炎是风湿病学家需要了解的一个重要疾病。与白塞病相关的视网膜血管炎对抗肿瘤坏死因子的单克隆抗体有反应，但许多其他形式的非感染性视网膜血管炎可能需要其他治疗方法。
