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炎症及抗炎治疗对急性前葡萄膜炎角膜内皮的影响。

The effects of inflammation and anti-inflammatory treatment on corneal endothelium in acute anterior uveitis.

作者信息

Ghiță Ana Cristina, Ilie Larisa, Ghiță Aurelian Mihai

机构信息

Ocularcare Eye Clinic, Bucharest, Romania.

Department of Ophthalmology, University Emergency Hospital, Bucharest, Romania.

出版信息

Rom J Ophthalmol. 2019 Apr-Jun;63(2):161-165.

Abstract

To establish the magnitude of endothelial cells alterations in acute anterior uveitis (AAU) and the clinical impact of local anti-inflammatory treatment. 27 patients at first episode of unilateral AAU were included. According to the moment of presentation in our departments, two different groups were created, early treatment uveitis group (ETUG) and delayed treatment uveitis group (DTUG). Each patient underwent a corneal endothelial specular microscopy, in both eyes, two weeks after we begun the topical treatment. A statistically significant endothelial cells loss in the uveitis eye was identified in both groups, more important in DTUG. Also, in this group, the pleomorfism, polimegathism and central corneal thickness (CCT) were statistically significant increased. The patients with unilateral AAU and delayed presentation showed more important alterations, first structural and then functional, due to a prolonged inflammatory response. This, in association with other favorable ocular conditions can progress to a permanent corneal endothelial decompensation. The sooner the anti-inflammatory treatment was initiated, the more limited were the destructive processes. AAU = Acute Anterior Uveitis, ETUG = Early Treatment Uveitis Group, DTUG = Delayed Treatment Uveitis Group, CCT = Central Corneal Thickness, CV = Coefficient of Variation, ECD = Endothelial Cells Density, HEX = Percentage of Hexagonal Cells.

摘要

确定急性前葡萄膜炎(AAU)中内皮细胞改变的程度以及局部抗炎治疗的临床影响。纳入27例单侧AAU初发患者。根据在我们科室就诊的时间,分为两个不同的组,早期治疗葡萄膜炎组(ETUG)和延迟治疗葡萄膜炎组(DTUG)。每位患者在开始局部治疗两周后,对双眼进行角膜内皮镜面显微镜检查。两组葡萄膜炎患眼中均发现内皮细胞有统计学意义的丢失,在DTUG组更为明显。此外,在该组中,多形性、大小不均和中央角膜厚度(CCT)有统计学意义的增加。单侧AAU且就诊延迟的患者由于炎症反应延长,显示出更明显的改变,首先是结构上的,然后是功能上的。这与其他有利的眼部情况相结合,可进展为永久性角膜内皮失代偿。抗炎治疗开始得越早,破坏性过程越有限。AAU = 急性前葡萄膜炎,ETUG = 早期治疗葡萄膜炎组,DTUG = 延迟治疗葡萄膜炎组,CCT = 中央角膜厚度,CV = 变异系数,ECD = 内皮细胞密度,HEX = 六边形细胞百分比

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