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与内源性后葡萄膜炎相关的脉络膜新生血管的免疫抑制治疗

Immunosuppressive treatment of choroidal neovascularization associated with endogenous posterior uveitis.

作者信息

Dees C, Arnold J J, Forrester J V, Dick A D

机构信息

Eye Department, Aberdeen Royal Infirmary, Scotland.

出版信息

Arch Ophthalmol. 1998 Nov;116(11):1456-61. doi: 10.1001/archopht.116.11.1456.

Abstract

OBJECTIVE

To determine whether resolution of choroidal neovascularization (CNV), a recognized sight-threatening complication of endogenous posterior uveitis, and maintenance of vision could be achieved with immunosuppression.

PATIENTS AND METHODS

Fourteen patients (17 eyes) with CNV associated with endogenous posterior uveitis were enrolled in an open study. Ages ranged from 5 to 51 years. Three eyes had extrafoveal CNV, 6 juxtafoveal, and 8 subfoveal. Three patients were treated with a single course of oral corticosteroids, 2 had additional cyclosporine for up to 2 years, and 9 continued to receive a low-dose regimen of a combination of immunosuppressive drugs.

RESULTS

After a median follow-up of 15 months (range, 7 months to 6 1/2 years), 9 of 17 eyes had an improvement in visual acuity; 6 remained within 1 Snellen line of initial visual acuity, and 2 had lost 2 Snellen lines. Angiographically, CNV resolved in 13 eyes, resolved then recurred in 3, and improved but persisted in 4.

CONCLUSION

These results support a role for immunosuppressive therapy in the treatment of CNV associated with endogenous posterior uveitis.

摘要

目的

确定免疫抑制治疗能否使脉络膜新生血管(CNV)消退,脉络膜新生血管是一种公认的内源性后葡萄膜炎致视力威胁性并发症,同时确定能否维持视力。

患者与方法

14例(17只眼)患有与内源性后葡萄膜炎相关的CNV患者纳入一项开放性研究。年龄范围为5至51岁。3只眼为黄斑中心凹外CNV,6只为黄斑中心凹旁,8只为黄斑中心凹下。3例患者接受了单疗程口服皮质类固醇治疗,2例额外接受环孢素治疗长达2年,9例继续接受低剂量免疫抑制药物联合治疗方案。

结果

中位随访15个月(范围7个月至6.5年)后,17只眼中9只眼视力提高;6只眼视力保持在初始视力1行以内,2只眼视力下降了2行。血管造影显示,13只眼的CNV消退,3只眼消退后复发,4只眼改善但仍持续存在。

结论

这些结果支持免疫抑制治疗在治疗与内源性后葡萄膜炎相关的CNV中发挥作用。

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