国际眼科纵览 ›› 2022, Vol. 46 ›› Issue (4): 296-303.doi: 10.3760/cma.j.issn.1673-5803.2022.04.002

• 综述 • 上一篇    下一篇

糖皮质激素性白内障的流行病学及发病机制

李晨爽1  严宏1, 2
  

  1. 1西安交通大学医学部 710061;2西安市人民医院  陕西省眼科医院 西安交通大学医学院附属广仁医院 710004

  • 收稿日期:2022-01-11 出版日期:2022-08-22 发布日期:2022-08-22
  • 通讯作者: 严宏,Email:yan2128ts@hotmail.com
  • 基金资助:
    国家自然科学基金面上项目(82070947);陕西省重点研发计划项目(2021ZDLSF-08);西安英才计划(XAYC200021)

Epidemiology and pathogenesis of glucocorticoid-induced cataract

Li Chenshuang1, Yan Hong1, 2   

  1. 1Xi'an Jiaotong University Health Science Center, Xi'an 710061, China; 2 Xi’an People's Hospital, Shaanxi Eye Hospital, Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, China

  • Received:2022-01-11 Online:2022-08-22 Published:2022-08-22
  • Contact: Yan Hong, Email: yan2128ts@hotmail.com
  • Supported by:
    National Natural Science Foundation of China (82070947); Key Program of Shaanxi Province (2021ZDLSF02-08); Xi'an Talent Program (XAYC200021)

摘要: 长期全身应用及眼局部应用糖皮质激素可引发糖皮质激素性白内障(glucocorticoid induced cataract,GIC),增加白内障患病风险。不同给药方式、剂量、剂型及合并不同全身性疾病引发白内障的风险不同,玻璃体注射长效缓释糖皮质激素患白内障的风险约为口服的3~5倍,口服累积每增加等效1 g泼尼松的糖皮质激素,白内障的患病风险为之前的1.03 倍,服用第3代糖皮质激素地夫可特的患者发生白内障的风险比服用泼尼松的患者高2.4倍。GIC的发病可能与糖皮质激素受体介导的蛋白质结构及功能改变、生长因子引起的细胞异常分化、细胞凋亡的激活、晶状体蛋白结构功能的改变及氧化应激等有关。(国际眼科纵览,2022, 46:296-303)


关键词: 糖皮质激素, 白内障

Abstract: The long-term use of systemic glucocorticoid as well as topical sustained-release preparations would result in glucocorticoid induced cataract (GIC), increasing the risk of both cortical and nuclear cataracts and making the onset of cataracts earlier than those of healthy people. The risk of cataracts is different according to different administration methods, doses, dosage forms and the disparate systemic diseases. For example, intravitreal injection of long-acting sustained-release glucocorticoids is about 3 to 5 times the risk of cataracts compared with oral administration. The risk of cataracts was 1.03 times higher for every additional 1 g of prednisone-equivalent cumulative oral hormone. The risk of cataracts was 2.4 times higher in patients taking the third-generation glucocorticoid Difloxacin than in patients taking prednisone. The pathogenesis of GIC has not been thoroughly elucidated, and the current research mainly focuses on glucocorticoid receptor-mediated changes in protein structure and function, abnormal cell differentiation caused by growth factors, excessive activation of apoptosis, changes in the structure and function of crystallins and oxidative stress. (Int Rev Ophthalmol, 2022, 46:  296-303)


Key words: glucocorticoid, cataract