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自身免疫性炎症性眼病:内科医生临床表现解析。

Autoimmune Inflammatory Eye Disease: Demystifying Clinical Presentations for the Internist.

机构信息

Department of Ophthalmology, Duke University School of Medicine, 2351 Erwin Road, Durham, NC, 27701, USA.

出版信息

Curr Allergy Asthma Rep. 2023 Aug;23(8):471-479. doi: 10.1007/s11882-023-01088-9. Epub 2023 Jul 12.

Abstract

PURPOSE OF REVIEW

Provide a framework for recognizing key symptoms and clinical findings in patients with autoimmune inflammatory eye disease.

RECENT FINDINGS

The most common manifestations of autoimmune inflammatory eye disease are episcleritis, scleritis, uveitis (anterior, intermediate, posterior, and panuveitis), and keratoconjunctivitis sicca. Etiologies can be idiopathic or in association with a systemic autoimmune condition. Referral of patients who may have scleritis is critical for patients presenting with red eyes. Referral of patients who may have uveitis is critical for patients presenting often with floaters and vision complaints. Attention should also be directed to aspects of the history that might suggest a diagnosis of a systemic autoimmune condition, immunosuppression, drug-induced uveitis, or the possibility of a masquerade condition. Infectious etiologies should be ruled out in all cases. Patients with autoimmune inflammatory eye disease may present with ocular or systemic symptoms alone, or in combination. Collaboration with ophthalmologists and other relevant specialists is vital to optimal long-term medical care.

摘要

目的综述

为识别自身免疫性炎症性眼病患者的关键症状和临床发现提供框架。

最近的发现

自身免疫性炎症性眼病最常见的表现为表层巩膜炎、巩膜炎、葡萄膜炎(前、中、后和全葡萄膜炎)和干燥性角结膜炎。病因可为特发性或与系统性自身免疫性疾病相关。对于可能患有巩膜炎的患者,转诊至关重要,因为这些患者通常表现为眼红。对于可能患有葡萄膜炎的患者,转诊至关重要,因为这些患者常表现为眼前漂浮物和视力问题。还应注意病史中可能提示系统性自身免疫性疾病、免疫抑制、药物性葡萄膜炎或伪装疾病诊断的方面。在所有情况下均应排除感染性病因。自身免疫性炎症性眼病患者可能仅表现为眼部或全身症状,或两者兼有。与眼科医生和其他相关专家合作对于获得最佳长期医疗护理至关重要。

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