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Fuchs葡萄膜炎的研究进展

王冰松 王涛   

  1. 首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科研究所 眼科学与视觉科学北京市重点实验室 100005
  • 收稿日期:2018-10-08 出版日期:2019-02-22 发布日期:2019-03-05
  • 通讯作者: 王涛,Email:stevenwa@126.com E-mail:stevenwa@126.com

Research progress of Fuchsu veitis

Wang Bingsong, Wang Tao   

  1. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Scienses, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
  • Received:2018-10-08 Online:2019-02-22 Published:2019-03-05
  • Contact: Wang Tao,Email:stevenwa@126.com E-mail:stevenwa@126.com

摘要:

Fuchs葡萄膜炎(fuchs uveitis,FU)是一种慢性、轻度的葡萄膜炎。越来越多的证据表明,风疹病毒感染与该病的发生有确切的相关性。该病也被命名为Fuchs虹膜异色性虹膜睫状体炎,但虹膜异色取决于虹膜色素上皮中的色素含量和虹膜萎缩的程度,许多患者不出现典型的虹膜异色,这是该病经常被延误诊断的原因。另外,近期的研究提示FU的炎症状态涉及到包括脉络膜的整个葡萄膜。该病的进展与并发白内障和继发青光眼相关。近年来文献报道多采用白内障超声乳化吸出合并囊袋内人工晶状体植入术治疗并发性白内障,尽管术中房角出血和术后前房炎性反应的并发症高于常规的白内障手术,多数患眼视力预后良好。继发青光眼的治疗通常更具挑战性,因其对药物、激光和手术治疗的反应比其他类型青光眼较差。如果采用小梁切除术,术中使用抗代谢药物可以提高手术成功率。近期有研究采用新型青光眼白内障联合手术对该病并发症进行治疗,尚有待远期的疗效观察结果。

Abstract:

Fuchs uveitis (FU) is a chronic, low\|grade inflammatory disorder involving the uvea. Evidence accumulates that there is no doubt that rubella virus infection have been implicated in the pathogenesis of the disease. FU is also named Fuchs’ heterochromic iridocyclitis. But heterochromia is variable depending on amount of pigment in the iris pigmented epithelium and the intensity of the anterior iris atrophy. The diagnosis might often be delayed due to the absence of heterochromia. In addition, recent researches showed that FU might be an inflammatory condition involving the whole uveal tunic. Progression of the disease is associated with cataract formation and glaucoma. Recently, phacoemulsification combined with intracapsular intraocular lens implantation has been widely reported in the treatment of complicated cataract.Although the complications of angle hemorrhage and anterior chamber inflammation are higher than those of conventional cataract surgery, most of the patients have good postoperative visual acuity.Therapy for glaucoma associated to FU is often more challenging because of its poor response to drugs, lasers and surgical treatment than other types of glaucoma. If trabeculectomy is used, intraoperative use of antimetabolic drugs can increase the success rate of surgery. Some researchers have used new combined glaucoma and cataract surgery to treat the complications of the disease recently, and the long\|term results need to be observed.