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[镰状细胞病中的黄斑病变]

[Maculopathy in sickle cell disease].

作者信息

Bachmeier Isabel, Blecha Christiane, Föll Jürgen, Wolff Daniel, Jägle Herbert

机构信息

Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.

Abteilung für Pädiatrische Hämatologie, Onkologie und Stammzelltransplantation, Universitätsklinikum Regensburg, Regensburg, Deutschland.

出版信息

Ophthalmologe. 2021 Oct;118(10):1013-1023. doi: 10.1007/s00347-020-01319-8. Epub 2021 Jan 27.

Abstract

BACKGROUND

Sickle cell disease (SCD) is a hereditary hemoglobinopathy, which leads to microcirculatory disturbances of various organ systems through recurrent vaso-occlusive episodes, with a possibly fatal outcome. Sickle cell retinopathy (SCR) is the best described ocular manifestation of SCD. Irrespective of the presence of peripheral SCR, sickle cell maculopathy (SCM) can occur early in the course of the disease.

METHODS

Review of the international and German literature on ocular involvement in SCD with a focus on SCR and SCM and an overview of current systemic therapeutic approaches in SCD on the occasion of the presentation of two patients with HbSS SCD.

RESULTS AND CONCLUSION

In contrast to SCR, SCM with temporal thinning of the inner retinal layers has only been increasingly described in the literature in the last 5 years, with the advent of SD-OCT and OCTA. Irrespective of the presence of SCR, as many as about half of the patients may develop SCM early in the course of the disease. As a result of progress in systemic therapeutic options and due to migration, the clinical picture will occur more often also in Germany. By knowing about this complication of SCD an early diagnosis can be made and unnecessary diagnostics can be avoided.

摘要

背景

镰状细胞病(SCD)是一种遗传性血红蛋白病,通过反复的血管闭塞性发作导致各个器官系统的微循环障碍,可能导致致命后果。镰状细胞视网膜病变(SCR)是SCD最典型的眼部表现。无论外周SCR是否存在,镰状细胞黄斑病变(SCM)都可能在疾病早期发生。

方法

回顾国际和德国关于SCD眼部受累情况的文献,重点关注SCR和SCM,并在介绍两名HbSS型SCD患者时概述SCD目前的全身治疗方法。

结果与结论

与SCR不同,随着频域光学相干断层扫描(SD-OCT)和光学相干断层扫描血管造影(OCTA)的出现,视网膜内层暂时变薄的SCM在过去5年的文献中才越来越多地被描述。无论SCR是否存在,约一半的患者可能在疾病早期发生SCM。由于全身治疗选择的进展以及移民因素,德国也会更频繁地出现这种临床情况。了解SCD的这种并发症有助于早期诊断并避免不必要的检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e5b/8492597/19f918c0a460/347_2020_1319_Fig1_HTML.jpg

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