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[眼部受累于大血管血管炎(巨细胞动脉炎和高安动脉炎)]

[Eye involvement in large vesssel vasculitis (giant cell arteritis and Takayasu's arteritis)].

作者信息

Neß Thomas, Schmidt Wolfgang

机构信息

Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.

Rheumatologie, Klinische Immunologie und Osteologie, Standort Berlin-Buch, Immanuel Krankenhaus Berlin, Berlin, Deutschland.

出版信息

Ophthalmologe. 2019 Sep;116(9):899-914. doi: 10.1007/s00347-019-00959-9.

Abstract

Giant cell arteritis (GCA) and Takayasu's arteritis are both forms of large vessel vasculitis and can be manifested in the eye. While GCA affects patients over the age of 50 years, patients with Takayasu's arteritis are between 15 and 30 years old. The diagnosis is based on a combination of anamnesis, imaging and systemic inflammatory reactions. The diagnosis can be confirmed by biopsy. Typical eye involvement of GCA are anterior ischemic optic neuropathy (AION) and central retinal artery occlusion, while Takayasu's arteritis involves hypertensive retinopathy and Takayasu's retinopathy (capillary dilatation, microaneurysms and arteriovenous anastomoses). The treatment consists of steroids in combination with classical immunosuppressants or biologics.

摘要

巨细胞动脉炎(GCA)和高安动脉炎均为大血管血管炎的形式,且可在眼部表现出来。虽然GCA影响50岁以上的患者,但高安动脉炎患者年龄在15至30岁之间。诊断基于病史、影像学检查和全身炎症反应。诊断可通过活检得以证实。GCA典型的眼部受累情况是前部缺血性视神经病变(AION)和视网膜中央动脉阻塞,而高安动脉炎则累及高血压性视网膜病变和高安视网膜病变(毛细血管扩张、微动脉瘤和动静脉吻合)。治疗包括使用类固醇联合传统免疫抑制剂或生物制剂。

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