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葡萄膜炎的历史:从古至今

The history of uveitis: from antiquity to the present day.

作者信息

Ghadiri Nima

机构信息

Department of Ophthalmology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.

Department of Eye and Vision Science, University of Liverpool, Liverpool, UK.

出版信息

Eye (Lond). 2025 Feb;39(3):488-491. doi: 10.1038/s41433-024-03519-x. Epub 2024 Dec 4.

Abstract

This comprehensive review traces the historical understanding and treatment of uveitis from ancient civilisations to modern medicine, a history which reflects the evolution of medical understanding and practice in general. Early descriptions of ocular inflammation appear in Egyptian medical papyri from 1700 BCE, with subsequent contributions from Greek and Roman physicians, including Hippocrates and Galen, who provided foundational observations of ocular inflammatory conditions. Medieval scholars in the Middle East, particularly Avicenna, preserved and advanced classical knowledge while recognising the systemic nature of ocular inflammation. The Renaissance and Enlightenment periods brought anatomical precision and the emergence of ophthalmology as a distinct specialty, notably through innovations such as Helmholtz's ophthalmoscope in 1851. The twentieth century marked a paradigm shift with the evolution of immunological understanding, leading to the recognition of autoimmune mechanisms and genetic predispositions in uveitis. The introduction of corticosteroids mid-century revolutionised treatment, followed by the development of steroid-sparing immunomodulatory agents and, more recently, targeted biological therapies. Contemporary advances in imaging technology and the establishment of international collaborative groups have standardised classification and treatment approaches. This historical perspective demonstrates the progression from empirical observations to precision medicine in uveitis, highlighting the importance of understanding this evolution for advancing future therapeutic strategies.

摘要

这篇全面的综述追溯了从古代文明到现代医学对葡萄膜炎的历史认识和治疗,这段历史反映了医学认识和实践的总体演变。眼部炎症的早期描述出现在公元前1700年的埃及医学纸莎草文献中,随后希腊和罗马的医生,包括希波克拉底和盖伦,做出了贡献,他们对眼部炎症状况进行了基础性观察。中东的中世纪学者,尤其是阿维森纳,在认识到眼部炎症的全身性本质的同时,保存并推进了古典知识。文艺复兴和启蒙运动时期带来了解剖学的精确性,眼科作为一个独特的专科出现,特别是通过1851年赫尔姆霍茨的检眼镜等创新。二十世纪随着免疫学认识的发展发生了范式转变,导致人们认识到葡萄膜炎中的自身免疫机制和遗传易感性。本世纪中叶皮质类固醇的引入彻底改变了治疗方法,随后是节省类固醇的免疫调节药物的开发,以及最近的靶向生物疗法。成像技术的当代进展和国际协作组的建立使分类和治疗方法标准化。这一历史视角展示了葡萄膜炎从经验观察到精准医学的发展历程,凸显了理解这一演变对推进未来治疗策略的重要性。

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