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阳光和紫外线辐射相关的视网膜影响及当前的治疗方法。

Sunlight and ultraviolet radiation-pertinent retinal implications and current management.

机构信息

Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts, USA.

Department of Ophthalmology and Visual Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA.

出版信息

Surv Ophthalmol. 2018 Mar-Apr;63(2):174-192. doi: 10.1016/j.survophthal.2017.09.002. Epub 2017 Sep 18.

DOI:10.1016/j.survophthal.2017.09.002
PMID:28923583
Abstract

Unprotected and prolonged exposure to ultraviolet (UV) light from sunlight, lasers, and arc welding leads to outer retinal damage. The photoreceptors and retinal pigment epithelium located in the posterior pole are particularly susceptible to this radiation. Classically known as solar retinopathy, this disorder frequently affects young individuals who have clear lenses and a propensity toward observing solar eclipses. Various imaging techniques aid the clinician in diagnosis, even if patients cannot recall an exposure event. By far the most utilized technique is optical coherence tomography that, in tandem with fluorescein angiography, and fundus autofluorescence, is crucial in ruling out other conditions. Fortunately, the prognosis of acute UV retinopathy is favorable, as most cases fully recover; however, a significant percentage of patients suffer from chronic sequelae: reduced acuity and lifelong central/paracentral scotomas. Thus, education toward understanding UV exposure risks, coupled with either abstinence or proper eye protection, is critical in preventing macular damage. We outline the various etiologies responsible for UV-induced retinopathy, describe the limited treatments available, and provide recommendations to minimize the potential devastating ophthalmic consequences as our society increases its reliance on UV-emitting technology and further engages in solar eclipse viewing.

摘要

未受保护的长时间暴露于阳光、激光和电弧焊接的紫外线 (UV) 光会导致外视网膜损伤。位于后极的光感受器和视网膜色素上皮对这种辐射特别敏感。这种疾病通常被称为太阳视网膜病变,常影响晶状体透明且有观察日食倾向的年轻人。各种成像技术有助于临床医生进行诊断,即使患者无法回忆起暴露事件。到目前为止,最常用的技术是光学相干断层扫描,它与荧光素血管造影和眼底自发荧光一起,对于排除其他疾病至关重要。幸运的是,急性 UV 视网膜病变的预后良好,因为大多数病例完全恢复;然而,相当一部分患者患有慢性后遗症:视力下降和终身中心/旁中心暗点。因此,通过教育了解 UV 暴露风险,并辅以禁欲或适当的眼部保护,对于预防黄斑损伤至关重要。我们概述了导致 UV 诱导的视网膜病变的各种病因,描述了现有的有限治疗方法,并提供了建议,以尽量减少潜在的破坏性眼科后果,因为我们的社会越来越依赖于发射紫外线的技术,并进一步参与日食观测。

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