治疗抵抗性葡萄膜炎的定义：共识缺失情况下的系统评价。
Definition of Uveitis Refractory to Treatment: A Systematic Review in the Absence of a Consensus.
机构信息
Laboratory of Ocular and Systemic Autoimmune Diseases, Faculty of Medicine, University of Chile, Santiago, Chile.
Departamento de Ciencias Químicas y Biológicas, Facultad de Salud, Universidad Bernardo O'Higgins, Santiago, Chile.
出版信息
Ocul Immunol Inflamm. 2022 Jan 2;30(1):174-179. doi: 10.1080/09273948.2020.1793369. Epub 2020 Sep 4.
PURPOSE
To evaluate the different definition of refractoriness in uveitis in the literature.
METHODS
We systematically searched the literature in order to identify definitions of refractory noninfectious uveitis in adult patients. A search strategy in the databases of MEDLINE and Scopus was used to find articles published between January 2005 and October 2018.
RESULTS
Definitions of corticosteroids-refractoriness were related to two main concepts: persistence of inflammation despite the use of corticosteroid and recurrences above a dosage threshold. In terms of immunomodulatory therapy and biologic agents, we observed a great variety of definitions: persistence of inflammation, number of attacks, side effects or complications, symptoms, and best-corrected visual acuity.
CONCLUSIONS
The results of this systematic review demonstrate the current lack of consensus on the definition for refractory uveitis, regardless of the treatment being used and revealed a new terminology based on a comprehensive and operational definition for each specific category of refractoriness.
目的
评估文献中葡萄膜炎难治性的不同定义。
方法
我们系统地检索了文献，以确定成人患者非感染性葡萄膜炎难治性的定义。在 MEDLINE 和 Scopus 数据库中使用了一种检索策略，以查找 2005 年 1 月至 2018 年 10 月期间发表的文章。
结果
皮质类固醇难治性的定义与两个主要概念有关：尽管使用皮质类固醇，但炎症仍持续存在，以及剂量阈值以上的复发。在免疫调节治疗和生物制剂方面，我们观察到了各种不同的定义：炎症持续存在、发作次数、副作用或并发症、症状和最佳矫正视力。
结论
这项系统评价的结果表明，目前无论使用何种治疗方法，对于难治性葡萄膜炎的定义都缺乏共识，并根据每种难治性具体类别提出了一种基于全面和可操作定义的新术语。
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