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老年眼中葡萄膜炎一瞥:病理生理学、临床表现及治疗考量

A Glimpse into Uveitis in the Aging Eye: Pathophysiology, Clinical Presentation and Treatment Considerations.

作者信息

Akinsoji Elizabeth, Goldhardt Raquel, Galor Anat

机构信息

University of Miami Miller School of Medicine, Miami, FL, USA.

Miami Veterans Administration Medical Center, Miami, FL, USA.

出版信息

Drugs Aging. 2018 May;35(5):399-408. doi: 10.1007/s40266-018-0545-3.

Abstract

Uveitis describes a group of inflammatory conditions of the eye that have various underlying causes and clinical presentations. Susceptibilities to uveitis in the elderly may be attributed to age-related risk factors such as immunosenescence, increased immunological inflammatory mediators, and autoimmunity. Overall, anterior uveitis is more common than posterior and panuveitis in the general population and also in the elderly. Some causes of uveitis in the elderly are herpes simplex virus, ocular ischemic syndrome, sarcoidosis, and central nervous system lymphoma, and these will be discussed in detail herein. Eye care professionals need to consider the wide differential for uveitis, obtain the appropriate history, conduct a detailed clinical examination, and tailor management to the clinical presentation and underlying cause of disease. The challenges of polypharmacy and nonadherence in the elderly impact patient outcomes and must be taken into consideration when considering treatment.

摘要

葡萄膜炎描述了一组眼部炎症性疾病,其病因和临床表现各不相同。老年人患葡萄膜炎的易感性可能归因于与年龄相关的风险因素,如免疫衰老、免疫炎症介质增加和自身免疫。总体而言,在普通人群以及老年人中,前葡萄膜炎比后葡萄膜炎和全葡萄膜炎更为常见。老年人葡萄膜炎的一些病因包括单纯疱疹病毒、眼部缺血综合征、结节病和中枢神经系统淋巴瘤,本文将对此进行详细讨论。眼科护理专业人员需要考虑葡萄膜炎的广泛鉴别诊断,获取适当的病史,进行详细的临床检查,并根据临床表现和潜在病因制定治疗方案。老年人多重用药和不依从的问题对患者的治疗结果有影响,在考虑治疗时必须予以考虑。

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