Ismailova D S, Novikov P I, Grusha Ya O, Abramova Yu V, Bulanov N M, Makarov E A
Research Institute of Eye Diseases, Moscow, Russia.
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia.
Ter Arkh. 2017;89(5):69-73. doi: 10.17116/terarkh201789569-73.
To estimate the frequency of lesions in the organ of vision in granulomatosis with polyangiitis (GPA) (Wegener's) and to determine their relationship to systemic diseases.
The retrospective study enrolled 218 patients followed up at the E.M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases, with a diagnosis of GPA. The frequency and association of ophthalmic manifestations with systemic involvement were statistically analyzed using PASW Statistics 18.
The organ of vision was impaired in 48.1% of the patients with GPA. The most common manifestations were orbital space-occupying lesion (22.9%), conjunctivitis/episcleritis (14.7%), dacryocystitis (6.0%), and scleritis (4.6%). Orbital space-occupying lesions occurred more frequently in the local type of the disease (p=0.0003), and, on the contrary, the involvement of the conjunctiva and eyeball was seen in patients with the systemic types of GPA (p=0.02).
The findings may suggest that the orbital lesion is an independent manifestation of GPA, which develops more commonly in its local type. Conjunctivitis/episcleritis is, on the contrary, more frequently seen in the active phase of the disease and generally in the involvement of other organs and systems.
评估显微镜下多血管炎（GPA）（韦格纳肉芽肿）患者眼部病变的发生率，并确定其与全身性疾病的关系。
这项回顾性研究纳入了218例在叶列夫肾脏病、内科与职业病诊所随访的诊断为GPA的患者。使用PASW Statistics 18对眼部表现与全身受累情况的发生率及相关性进行统计学分析。
48.1%的GPA患者存在眼部损害。最常见的表现为眼眶占位性病变（22.9%）、结膜炎/巩膜外层炎（14.7%）、泪囊炎（6.0%）和巩膜炎（4.6%）。眼眶占位性病变在局限性疾病类型中更为常见（p = 0.0003），相反，全身性GPA患者可见结膜和眼球受累（p = 0.02）。
研究结果可能提示眼眶病变是GPA的一种独立表现，在局限性疾病类型中更常见。相反，结膜炎/巩膜外层炎在疾病的活动期以及其他器官和系统受累时更常见。
