Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Ophthalmology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
Ocul Immunol Inflamm. 2021 Jul 4;29(5):991-996. doi: 10.1080/09273948.2020.1712432. Epub 2020 Feb 20.
To investigate ocular manifestations in patients positive for serum anti-neutrophil cytoplasmic antibodies (ANCAs) in Japan.: The clinical records of patients who had ocular manifestations and who were serum ANCA positive between 2011-2017 at Tokyo Medical and Dental University Hospital were retrospectively reviewed.: Eighteen patients were identified to be positive for serum ANCA and had ocular manifestations, including optic nerve involvement (50%), scleritis (27.8%), iritis (27.8%), retinal vasculitis (16.7%), oculomotor disorder (16.7%), and peripheral ulcerative keratitis (11.1%). Six patients had ANCA-associated vasculitis (AAV), including 5 patients with granulomatosis with polyangiitis and 1 patient with microscopic polyangiitis. Most patients with optic nerve involvement were myeloperoxidase-ANCA positive. Contrastingly, most patients with anterior segment involvement were proteinase-3-ANCA positive.: Ocular manifestations were observed in some patients positive for serum ANCAs. Serum ANCA evaluation is useful for identifying the etiology of ocular inflammation and for diagnosing AAV, a life-threatening disease.
目的:调查日本血清抗中性粒细胞胞浆抗体(ANCA)阳性患者的眼部表现。方法:回顾性分析 2011 年至 2017 年在东京医科齿科大学医院就诊的血清 ANCA 阳性且有眼部表现的患者的临床资料。结果:共发现 18 例血清 ANCA 阳性且有眼部表现的患者,包括视神经受累(50%)、巩膜炎(27.8%)、虹膜炎(27.8%)、视网膜血管炎(16.7%)、眼外肌障碍(16.7%)和周边溃疡性角膜炎(11.1%)。6 例患者为抗中性粒细胞胞浆抗体相关血管炎(AAV),包括 5 例肉芽肿性多血管炎和 1 例显微镜下多血管炎。视神经受累患者多数为髓过氧化物酶-ANCA 阳性。相反,前节受累患者多数为蛋白酶 3-ANCA 阳性。结论:一些血清 ANCA 阳性患者出现眼部表现。血清 ANCA 评估有助于确定眼部炎症的病因,并诊断危及生命的 AAV。