Karma A
Univ.-Augenklinik Oulu/Finnland.
Klin Monbl Augenheilkd. 1987 Oct;191(4):253-9. doi: 10.1055/s-2008-1050504.
The present paper deals with the frequency of different ophthalmic sarcoid changes and their morphological and photographic characteristics. In addition, the diagnostic value of conjunctival biopsy is evaluated. The findings were based on repeated ophthalmological examinations of an unselected group of 281 patients with histologically confirmed sarcoidosis. Conjunctival (37/218) and lacrimal gland (33/254) changes were encountered more often than sarcoid uveitis (22/281), and a conjunctival granuloma was the most frequent single sarcoid ophthalmic finding. Sarcoid changes in the eyes and the adnexae were often characterized by a scarcity of symptoms and a typical outward appearance. In some cases of sarcoid uveitis fluorescein angiography revealed in the iris and the retina nodules which showed features suggesting the proliferative nature of the disease. The iris infrared transillumination technique illustrated the affinity of sarcoid nodules in the pupillary area. Conjunctival biopsy showed epithelioid cell granulomas compatible with sarcoidosis in nearly half of the patients in whom it was suspected in a slit-lamp examination of the conjunctivae. In the diagnosis of sarcoidosis, conjunctival biopsy is a procedure to be recommended before more demanding methods are tried.
本文探讨了不同眼部结节病病变的发生率及其形态学和影像学特征。此外，还评估了结膜活检的诊断价值。研究结果基于对281例经组织学确诊为结节病的患者进行的多次眼科检查，这些患者均为未经过筛选的。结膜病变（37/218）和泪腺病变（33/254）比结节病性葡萄膜炎（22/281）更为常见，结膜肉芽肿是最常见的单一眼部结节病表现。眼部和附属器的结节病病变通常症状较少且外观典型。在一些结节病性葡萄膜炎病例中，荧光素血管造影显示虹膜和视网膜有结节，这些结节具有提示疾病增殖性质的特征。虹膜红外透照技术显示了结节病结节在瞳孔区的亲和性。在裂隙灯检查结膜怀疑有病变的患者中，近一半的结膜活检显示上皮样细胞肉芽肿，与结节病相符。在结节病的诊断中，结膜活检是在尝试更复杂的方法之前推荐采用的一种检查。
