Ismailova D S, Grusha Y O, Abramova Yu V, Novikov P I, Danilov S S
Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021.
Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021; I.M. Sechenov First Moscow State Medical University, Chair of Ophthalmology, 8-2 Trubetskaya St., Moscow, Russian Federation, 119991.
Vestn Oftalmol. 2018;134(5. Vyp. 2):178-185. doi: 10.17116/oftalma2018134051178.
One of the most common and potentially threatening manifestations of granulomatosis with polyangiitis (GPA) is orbital lesion.
To study the clinical course and prognosis of orbital lesions of various localization in GPA patients. Material and me-thods. The study included 226 patients with GPA, 74 of them with orbital lesion. Ophthalmic examination consisted of visual acuity test, biomicroscopy, ophthalmoscopy, exophthalmometry and ocular mobility test. Visualization was done using multislice computed tomography and/or magnetic resonance tomography and/or ultrasound examination.
Among the patients of the study group, in 35.1% the lesion was limited to dacryoadenitis, in 4.0% of patients - to myositis, and 70.8% had extensive inflammatory orbital masses. Patients with orbital masses had systemic disease in 51.1%, compared to 7.7% in dacryoadenitis (p=0.00). Clinical progression in patients with orbital masses was characterized by severe exophthalmos, periorbital swelling and hyperemia. Patients with dacryoadenitis, on the contrary, had only mild symptoms. Patients with orbital masses had unfavorable prognosis. There were only three patients with myositis in the study group, so the data on them is limited; their clinical symptoms included light periorbital swelling, exophthalmos, strabismus, painful binocular diplopia and eye movement restriction. The disease was recurring in two cases.
Patients with orbital involvement in GPA may have different course of the disease depending on the localization of inflammation.
肉芽肿性多血管炎（GPA）最常见且可能具有威胁性的表现之一是眼眶病变。
研究GPA患者不同部位眼眶病变的临床病程及预后。材料与方法。该研究纳入了226例GPA患者，其中74例有眼眶病变。眼科检查包括视力测试、生物显微镜检查、检眼镜检查、眼球突出度测量和眼球运动测试。使用多层计算机断层扫描和/或磁共振断层扫描和/或超声检查进行可视化。
在研究组患者中，35.1%的病变局限于泪腺炎，4.0%的患者为肌炎，70.8%有广泛的炎性眼眶肿块。有眼眶肿块的患者51.1%有全身性疾病，而泪腺炎患者为7.7%（p = 0.00）。有眼眶肿块的患者临床进展表现为严重眼球突出、眶周肿胀和充血。相反，泪腺炎患者仅有轻微症状。有眼眶肿块的患者预后不良。研究组仅有3例肌炎患者，因此关于他们的数据有限；他们的临床症状包括轻度眶周肿胀、眼球突出、斜视、疼痛性双眼复视和眼球运动受限。该疾病在2例中复发。
GPA眼眶受累患者可能因炎症部位不同而有不同的病程。
