Pichi Francesco, Veronese Chiara, Lembo Andrea, Invernizzi Alessandro, Mantovani Alessandro, Herbort Carl P, Cunningham Emmett T, Morara Mariachiara, Ricci Federico, Neri Piergiorgio, Nucci Paolo, Ciardella Antonio P, Staurenghi Giovanni, Lowder Careen Y, Srivastava Sunil K
Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
San Giuseppe Hospital, University Eye Clinic, Milan, Italy.
Br J Ophthalmol. 2017 Mar;101(3):316-321. doi: 10.1136/bjophthalmol-2015-308246. Epub 2016 Jun 6.
Kyrieleis retinal periarteritis reflects the severe intraocular inflammation experienced by the eye. Its aetiology has not been well established, since only nine cases have been reported and there is no pathological study available in the literature. We determine the pathogenesis of Kyrieleis periarteritis based on interpretation of multimodal imaging findings.
Charts of patients with Kyrieleis arteritis seen between 2006 and 2014 were retrieved from eight uveitis referral centres throughout the world. Follow-up ranged from 5 to 12 months.
Twenty-five eyes with Kyrieleis arteritis from 25 patients were included in the study. Nineteen patients (72%) were male and six (28%) were female. Twenty-three patients were diagnosed with toxoplasmosis retinochoroiditis and two patients had cytomegalovirus retinitis. Fluorescein angiography, fundus autofluorescence and indocyanine green angiography were performed on 25/25 (100%) eyes. In eight eyes (32%), baseline spectral domain optical coherence tomography (SD-OCT) scans were performed along the segmental Kyrieleis arteritis. Fluorescein angiography showed early hypofluorescence and intermediate hyperfluorescence associated with the areas of focal arteritis, whereas indocyanine green angiography of these accumulations showed early hypofluorescence and late hyperfluorescence. Fundus autofluorescence revealed an increased autofluorescence of the vessels corresponding to the Kyrieleis plaques, while SD-OCT scans along the segmental Kyrieleis arteritis showed hyperreflectivity of the vessel wall.
These imaging modalities provide in vivo, quasi-histologic images demonstrating that Kyrieleis plaques are characterised by an inflammatory involvement within the vessels' endothelium.
基里埃利斯视网膜动脉周炎反映了眼部经历的严重眼内炎症。其病因尚未明确确立，因为仅报告了9例病例，且文献中尚无病理学研究。我们基于多模态成像结果的解读来确定基里埃利斯动脉周炎的发病机制。
检索了2006年至2014年间在全球八个葡萄膜炎转诊中心就诊的基里埃利斯动脉炎患者的病历。随访时间为5至12个月。
本研究纳入了25例患者的25只患有基里埃利斯动脉炎的眼睛。19例（72%）为男性，6例（28%）为女性。23例患者被诊断为弓形虫性视网膜脉络膜炎，2例患者患有巨细胞病毒性视网膜炎。对25只（100%）眼睛进行了荧光素血管造影、眼底自发荧光和吲哚菁绿血管造影。8只眼睛（32%）在节段性基里埃利斯动脉炎部位进行了基线光谱域光学相干断层扫描（SD - OCT）。荧光素血管造影显示与局灶性动脉炎区域相关的早期低荧光和中期高荧光，而这些积聚部位的吲哚菁绿血管造影显示早期低荧光和晚期高荧光。眼底自发荧光显示与基里埃利斯斑块相对应的血管自发荧光增强，而沿节段性基里埃利斯动脉炎的SD - OCT扫描显示血管壁高反射性。
这些成像方式提供了体内准组织学图像，表明基里埃利斯斑块的特征是血管内皮的炎症累及。
