Bentley C R, Stanford M R, Shilling J S, Sanders M D, Graham E M
Medical Eye Unit, St. Thomas' Hospital, London, UK.
Eye (Lond). 1993;7 ( Pt 3):411-4. doi: 10.1038/eye.1993.81.
The commonest cause of visual morbidity in patients with posterior uveitis is cystoid macular oedema, which usually responds to immunosuppressive treatment. However, a small group of patients do not have a satisfactory visual outcome despite apparently adequate therapy. In a retrospective study of 345 angiograms of 135 patients with active non-occlusive retinal vasculitis 12 patients were identified by independent masked review as showing macular ischaemia on their fluorescein angiograms. Four patients had Behçet's disease, 4 sarcoidosis, and 4 idiopathic retinal vasculitis. Follow-up of these patients for an average of 36 months (range 6-120 months) showed that visual acuity failed to improve in 4 patients and dropped by an average of three lines Snellen in the other 8. We suggest that a poor visual outcome in some patients with posterior uveitis may be predicted by the presence of macular ischaemia on fluorescein angiography and that immunosuppressive therapy should be prescribed with caution in these patients.
后葡萄膜炎患者视力受损的最常见原因是黄斑囊样水肿，这种情况通常对免疫抑制治疗有反应。然而，一小部分患者尽管接受了看似充分的治疗，视力预后仍不理想。在一项对135例活动性非闭塞性视网膜血管炎患者的345张血管造影照片的回顾性研究中，通过独立的盲法评估，确定有12例患者的荧光素血管造影显示黄斑缺血。其中4例患有白塞病，4例患有结节病，4例患有特发性视网膜血管炎。对这些患者平均随访36个月（范围6 - 120个月），结果显示4例患者视力未改善，另外8例患者视力平均下降了Snellen视力表的3行。我们认为，荧光素血管造影显示黄斑缺血可能预示着一些后葡萄膜炎患者视力预后不佳，对于这些患者应谨慎使用免疫抑制治疗。
