Sfiniadaki Evdokia, Tsiara Ioanna, Theodossiadis Panagiotis, Chatziralli Irini
Medical School, National and Kapodistrian University of Athens, Athens, Greece.
2nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece.
Ophthalmol Ther. 2019 Jun;8(2):227-234. doi: 10.1007/s40123-019-0176-8. Epub 2019 Mar 15.
Granulomatosis with polyangiitis (GPA) is a rare systemic autoimmune disease of unknown etiology that is characterized by granulomatous inflammation, tissue necrosis, and vasculitis in small- and medium-sized vessels. Ocular and orbital manifestations are common in almost half of patients with GPA, affecting every structure of the eye, from the eyelid and orbit to the retina, the choroid, and the optic nerve, with a wide range of severity. Since imaging findings are not always specific for the diagnosis of GPA, biopsy is useful to confirm the diagnosis. Regarding treatment, a localized pharmaceutical and surgical approach may be helpful to achieve remission, while immunosuppressive therapy, corticosteroids, and cyclosporine are also useful. In any case, multidisciplinary intervention is required to reduce the rates of relapse and morbidity in patients with GPA.
肉芽肿性多血管炎(GPA)是一种病因不明的罕见全身性自身免疫性疾病,其特征为肉芽肿性炎症、组织坏死以及中小血管的血管炎。眼部和眼眶表现几乎见于近半数的GPA患者,累及从眼睑、眼眶到视网膜、脉络膜及视神经的眼部各个结构,严重程度差异很大。由于影像学表现对GPA诊断并不总是具有特异性,活检有助于确诊。在治疗方面,局部药物和手术治疗方法可能有助于实现缓解,而免疫抑制治疗、皮质类固醇和环孢素也有作用。无论如何,都需要多学科干预以降低GPA患者的复发率和发病率。