Lee Joanne H, Agarwal Aniruddha, Mahendradas Padmamalini, Lee Cecilia S, Gupta Vishali, Pavesio Carlos E, Agrawal Rupesh
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Department of Vitreoretina and Uveitis, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Surv Ophthalmol. 2017 Jul-Aug;62(4):404-445. doi: 10.1016/j.survophthal.2016.12.008. Epub 2016 Dec 22.
The causes of posterior uveitis can be divided into infectious, autoimmune, or masquerade syndromes. Viral infections, a significant cause of sight-threatening ocular diseases in the posterior segment, include human herpesviruses, measles, rubella, and arboviruses such as dengue, West Nile, and chikungunya virus. Viral posterior uveitis may occur as an isolated ocular disease in congenital or acquired infections or as part of a systemic viral illness. Many viruses remain latent in the infected host with a risk of reactivation that depends on various factors, including virulence and host immunity, age, and comorbidities. Although some viral illnesses are self-limiting and have a good visual prognosis, others, such as cytomegalovirus retinitis or acute retinal necrosis, may result in serious complications and profound vision loss. Since some of these infections may respond well to antiviral therapy, it is important to work up all cases of posterior uveitis to rule out an infectious etiology. We review the clinical features, diagnostic tools, treatment regimens, and long-term outcomes for each of these viral posterior uveitides.
后葡萄膜炎的病因可分为感染性、自身免疫性或伪装综合征。病毒感染是后段威胁视力的眼部疾病的重要原因,包括人类疱疹病毒、麻疹、风疹以及登革热、西尼罗河病毒和基孔肯雅病毒等虫媒病毒。病毒性后葡萄膜炎可作为先天性或获得性感染中的一种孤立性眼部疾病出现,或作为全身性病毒疾病的一部分出现。许多病毒在受感染宿主中保持潜伏状态,存在重新激活的风险,这取决于多种因素,包括毒力、宿主免疫力、年龄和合并症。虽然一些病毒疾病是自限性的,视力预后良好,但其他疾病,如巨细胞病毒性视网膜炎或急性视网膜坏死,可能导致严重并发症和严重视力丧失。由于其中一些感染对抗病毒治疗可能反应良好,因此对所有后葡萄膜炎病例进行检查以排除感染性病因很重要。我们回顾了每种病毒性后葡萄膜炎的临床特征、诊断工具、治疗方案和长期预后。