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眼部结节病的临床表现、并发症及治疗:光学相干断层扫描显示的视觉效率与黄斑水肿之间的相关性

Clinical Manifestations, Complications and Treatment of Ocular Sarcoidosis: Correlation between Visual Efficiency and Macular Edema as Seen on Optical Coherence Tomography.

作者信息

Paovic Jelena, Paovic Predrag, Sredovic Vojislav, Jovanovic Svetlana

机构信息

a University Eye Clinic , Clinical Center of Serbia , Belgrade , Serbia.

b Primary Health Care Center , Pecinci , Serbia.

出版信息

Semin Ophthalmol. 2016 Sep 14:1-8. doi: 10.1080/08820538.2016.1206576.

DOI:10.1080/08820538.2016.1206576
PMID:27628176
Abstract

Sarcoidosis is a chronic systemic autoimmune disease which belongs to a group of systemic granulomatous diseases. It can be confirmed through characteristic systemic and ocular manifestations and histological findings. Biopsy is the golden standard for diagnosing sarcoidosis. Ocular sarcoidosis can be confirmed, probable, or possible. Over a two-year period, ocular manifestations were studied on a sample of 52 patients, each followed for four months and diagnosed with some form of systemic sarcoidosis. Most frequent systemic manifestations in patients with ocular sarcoidosis were pulmonary, skin, glandular, and systemic generalized sarcoidosis. The disease was diagnosed four times more frequently in females than males (42:10, respectively; p < 0.05). Most frequent, and statistically significant, manifestation of ocular sarcoidosis is anterior uveitis (64.61%; p < 0.01). Macular edema and periphlebitis associated with periarteritis were frequent, and statistically significant (43.90% and 29.26%, respectively; p < 0.05). Overall, with regards to gender and location (right eye; left eye), visual acuity was >0.5 and of statistical significance (76.92%; p < 0.01). The most common therapy consisted of systemic corticosteroids (26.67%) and/or a combination of corticosteroids and immunosuppressive drugs (23.33%). In 16 eyes treated with repeated doses of sub-Tenon's injections, both initial and control visual acuity correlated with average thickness. There was positive correlation between several optical coherence tomography findings before and after treatment.

摘要

结节病是一种慢性全身性自身免疫性疾病,属于全身性肉芽肿性疾病。可通过特征性的全身和眼部表现以及组织学检查结果来确诊。活检是诊断结节病的金标准。眼部结节病可确诊、可能或疑似。在两年时间里,对52例患者的样本进行了眼部表现研究,每位患者随访4个月,均被诊断为某种形式的全身性结节病。眼部结节病患者最常见的全身表现为肺部、皮肤、腺体和全身性结节病。女性患者的疾病诊断率是男性的四倍(分别为42例和10例;p<0.05)。眼部结节病最常见且具有统计学意义的表现是前葡萄膜炎(64.61%;p<0.01)。黄斑水肿和与动脉周围炎相关的静脉周围炎很常见,且具有统计学意义(分别为43.90%和29.26%;p<0.05)。总体而言,就性别和部位(右眼;左眼)而言,视力>0.5且具有统计学意义(76.92%;p<0.01)。最常见的治疗方法包括全身性皮质类固醇(26.67%)和/或皮质类固醇与免疫抑制药物的联合使用(23.33%)。在16只接受重复剂量的Tenon囊下注射治疗的眼睛中,初始视力和对照视力均与平均厚度相关。治疗前后的几项光学相干断层扫描结果之间存在正相关。

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