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点状内层脉络膜病变:综述

Punctate inner choroidopathy: A review.

作者信息

Ahnood Dana, Madhusudhan Savitha, Tsaloumas Marie D, Waheed Nadia K, Keane Pearse A, Denniston Alastair K

机构信息

Department of Ophthalmology, Royal Glamorgan Hospital, Cwm Taf University Health Board, Cardiff, United Kingdom.

St. Paul's Eye Unit, Royal Liverpool University Hospital, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom.

出版信息

Surv Ophthalmol. 2017 Mar-Apr;62(2):113-126. doi: 10.1016/j.survophthal.2016.10.003. Epub 2016 Oct 15.

Abstract

Punctate inner choroidopathy (PIC), an idiopathic inflammatory multifocal chorioretinopathy that predominantly affects young myopic women, appears to be relatively rare, but there are limited data to support accurate estimates of prevalence, and it is likely that the condition is underdiagnosed. The etiological relationship between PIC and other conditions within the "white dot syndromes" group remains uncertain. We, like others, would suggest that PIC and multifocal choroiditis with panuveitis represent a single disease process that is modified by host factors (including host immunoregulation) to cause the range of clinical phenotypes seen. The impact of PIC on the patient is highly variable, with outcome ranging from complete spontaneous recovery to bilateral severe sight loss. Detection and monitoring have been greatly facilitated by modern scanning techniques, especially optical coherence tomography and autofluorescence imaging and may be enhanced by coregistration of sequential images to detect change over time. Depending on the course of disease and nature of complications, appropriate treatment may range from observation to systemic immunosuppression and antiangiogenic therapies. PIC is a challenging condition where treatment has to be tailored to the patient's individual circumstances, the extent of disease, and the risk of progression.

摘要

点状内层脉络膜病变(PIC)是一种特发性炎症性多灶性脉络膜视网膜病变,主要影响年轻近视女性,似乎相对少见,但支持准确患病率估计的数据有限,而且这种疾病很可能诊断不足。PIC与“白点综合征”组内其他病症之间的病因关系仍不确定。与其他人一样,我们认为PIC和伴有全葡萄膜炎的多灶性脉络膜炎代表了一个单一的疾病过程,该过程会因宿主因素(包括宿主免疫调节)而发生改变,从而导致出现一系列临床表型。PIC对患者的影响差异很大,结果从完全自发恢复到双侧严重视力丧失不等。现代扫描技术,尤其是光学相干断层扫描和自发荧光成像极大地促进了疾病的检测和监测,通过对序列图像进行配准以检测随时间的变化可能会进一步增强这种效果。根据疾病进程和并发症的性质,适当的治疗方法可能从观察到全身免疫抑制和抗血管生成治疗不等。PIC是一种具有挑战性的病症,治疗必须根据患者的个体情况、疾病程度和进展风险进行调整。

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