国际眼科纵览

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人巨细胞病毒眼前节炎症的发病机制及其治疗策略

王鸽纯  袁非   

  1. 复旦大学附属中山医院眼科,上海 200032
  • 收稿日期:2019-10-27 出版日期:2020-06-22 发布日期:2020-06-22
  • 通讯作者: 袁非,Email: yuan.fei@zs-hospital.sh.cn

Pathogenesis and new treatment strategies of human cytomegalovirus anterior segment inflammation

Wang Gechun, Yuan Fei   

  1. Department of Ophthalmology,  Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
  • Received:2019-10-27 Online:2020-06-22 Published:2020-06-22
  • Contact: Yuan Fei, Email: yuan.fei@zs-hospital.sh.cn

摘要: 人巨细胞病毒(human cytomegalovirus,hCMV)眼前节感染常表现为角膜内皮炎和前葡萄膜炎。hCMV角膜内皮炎可能与角膜内皮细胞(corneal endothelium cell,CEC)中hCMV的复制或前房相关免疫偏离有关。治疗需针对炎性成分和病毒本身,可全身或局部使用更昔洛韦联合局部糖皮质激素治疗。hCMV前葡萄膜炎常表现为Posner-Schlossman综合征和Fuchs综合征。hCMV对CEC和小梁网细胞较高的亲和力常引起CEC密度降低和难以控制的高眼压,并可进一步发展为继发性青光眼。当糖皮质激素、抗病毒和降眼压药物治疗无效时,需要及时行抗青光眼手术等治疗。(国际眼科纵览, 2020, 44:202-206)

Abstract: Human cytomegalovirus (hCMV) anterior segment infections often manifest as corneal endotheliitis and anterior uveitis. HCMV corneal endotheliitis may be caused by hCMV replication in corneal endothelial cells (CEC) or anterior chamber associated immune deviation. Treatment needs to target the inflammatory components and the virus itself, and systemic or local ganciclovir combined with local glucocorticoid therapy can be used. HCMV anterior uveitis can manifest as Posner-Schlossman syndrome (PSS) and Fuchs syndrome. The high affinity of hCMV for CEC and trabecular meshwork cells often leads to a decrease in CEC density and an uncontrollable increase in intraocular pressure. HCMV anterior uveitis can develop as secondary glaucoma. When corticosteroids, antiviral and antihypertensive medicines are ineffective, glaucoma surgery and other treatments need to be performed in time. (Int Rev Ophthalmol, 2020, 44:202-206)