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青少年特发性关节炎伴葡萄膜炎患者随访超过16年的一种不寻常视网膜血管改变

An Unusual Retinal Vessel Modification in Patients Affected by JIA-Uveitis with a Follow-Up Longer Than 16 Years.

作者信息

Abbouda Alessandro, Abicca Irene, Bruschi Simone, Ricci Federico, Aloe Gianluca, Paroli Maria Pia

机构信息

Department of Ophthalmology, Sapienza University, Umberto I Hospital, Rome, Italy.

IRCCS-Fondazione Bietti, Rome, Italy.

出版信息

Case Rep Ophthalmol Med. 2020 Jan 28;2020:4720819. doi: 10.1155/2020/4720819. eCollection 2020.

Abstract

PURPOSE

To report unusual and rare clinical changes of retinal vessel pattern in a series of patients affected by Juvenile Idiopathic Arthritis (JIA) uveitis with a follow-up longer than 16 years.

METHODS

A series of three patients with JIA-uveitis followed at the University of Rome "Sapienza" from 1998 to 2014 were reported. The retinal vessels were analyzed with fluorescein angiography using Heidelberg Retinal Angiogram-2 (HRA-2; Heidelberg Engineering GmBH, Dossenheim, Germany) and the Topcon TRC-50LX retinal camera (Topcon Europe, The Netherlands). A Spectralis Domain OCT (SD-OCT) (Spectralis Family Heidelberg, Germany) was performed to evaluate vessel anatomy.

RESULTS

Fundus photography showed sheathed vessels localized around the optic disc in every case. Angiography revealed a normal physiology of vessel walls and flow; no sheathing or leakage of dye was observed. SD-OCT demonstrated reflective vessel walls. Vessel lumen appeared patent, and the normal "" was blurred, but identifiable.

CONCLUSIONS

Vessel modifications observed in long-standing JIA-uveitis are not signs of vascular inflammation and are not associated to hypoperfusion. In these cases, ophthalmologists should avoid further invasive investigation and should consider introducing SD-OCT as a routine method to evaluate the vessel changes during the follow-up.

摘要

目的

报告一系列青少年特发性关节炎(JIA)葡萄膜炎患者随访超过16年的视网膜血管模式异常和罕见临床变化。

方法

报告了1998年至2014年在罗马“萨皮恩扎”大学随访的3例JIA葡萄膜炎患者。使用海德堡视网膜血管造影仪-2(HRA-2;德国海德堡工程公司,多森海姆)和拓普康TRC-50LX视网膜相机(荷兰拓普康欧洲公司)通过荧光素血管造影分析视网膜血管。使用光谱域光学相干断层扫描(SD-OCT)(德国海德堡光谱域家族)评估血管解剖结构。

结果

眼底摄影显示每例患者视盘周围均有血管鞘。血管造影显示血管壁和血流生理正常;未观察到染料鞘或渗漏。SD-OCT显示血管壁有反射。血管腔通畅,正常的“”模糊但可识别。

结论

在长期JIA葡萄膜炎中观察到的血管改变不是血管炎症的迹象,也与灌注不足无关。在这些情况下,眼科医生应避免进一步的侵入性检查,并应考虑引入SD-OCT作为随访期间评估血管变化的常规方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12b0/7008287/6657ad7ea32b/CRIOPM2020-4720819.001.jpg

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