Anglade E, Whitcup S M
Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA.
Drugs. 1995 Feb;49(2):213-23. doi: 10.2165/00003495-199549020-00006.
The diagnosis and management of uveitis is complicated and challenging. The protean signs and symptoms seen in patients with uveitis may lead to a diagnostic dilemma. A carefully taken history with particular attention to demographic factors and meticulous physical examination are crucial to guiding diagnostic testing. Tailoring the diagnostic approach in patients with uveitis frequently yields useful data in contrast to blanketing every possible uveitic entity. It is also important to distinguish among various aetiologies, including infectious and neoplastic causes which may respond to specific therapy. Medical treatment of noninfectious uveitis must have clear objectives including reduction of inflammation, relief of symptoms and restoration of visual functioning. Familiarity with possible symptoms and signs of adverse drug reactions is essential early in the course of treatment so that their effects may be minimised. Appropriate therapy of presumed autoimmune uveitis is based on disease severity, presence or absence of bilateral disease and the health status of the patient.
葡萄膜炎的诊断和管理复杂且具有挑战性。葡萄膜炎患者出现的各种体征和症状可能导致诊断困境。仔细询问病史,尤其关注人口统计学因素,并进行细致的体格检查,对于指导诊断性检查至关重要。与对每一种可能的葡萄膜炎实体进行全面筛查相比,针对葡萄膜炎患者量身定制诊断方法往往能获得有用的数据。区分各种病因也很重要,包括可能对特定治疗有反应的感染性和肿瘤性病因。非感染性葡萄膜炎的药物治疗必须有明确的目标,包括减轻炎症、缓解症状和恢复视觉功能。在治疗过程早期熟悉药物不良反应的可能症状和体征至关重要,以便将其影响降至最低。假定的自身免疫性葡萄膜炎的适当治疗基于疾病严重程度、双侧疾病的有无以及患者的健康状况。