国际眼科纵览

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眼眶IgG4相关眼病的研究进展

吴华蓉1 高雯2 张光虹2 田艳明2   

  1. 1新疆石河子大学医学院,石河子 832002;2新疆军区总医院北京路医疗区,乌鲁木齐 830013
  • 收稿日期:2019-12-19 出版日期:2020-08-22 发布日期:2020-09-01
  • 通讯作者: 田艳明,Email:tianyanming@163.com E-mail:tianyanming@163.com

Novel advances on orbital IgG4-related ocular diseases

Wu Huarong 1, Gao Wen 2, Zhang Guanghong 2, Tian Yanming 2   

  1. 1 The Shihezi University School of Medicine, Shihezi 832002, Xinjiang Uygur Autonomous Region, China;2 Beijing Road Medical District, Xinjiang Military General Hospital, Urumqi 830013, Xinjiang Uygur Autonomous Region, China
  • Received:2019-12-19 Online:2020-08-22 Published:2020-09-01
  • Contact: Tian Yanming, Email: tianyanming@163.com E-mail:tianyanming@163.com

摘要: IgG4相关眼病(IgG4-related ocular disease,IgG4-ROD)是近年新发现的一种自身免疫性疾病,组织学上可见大量淋巴细胞和浆细胞浸润、闭塞性静脉炎及席文状或旋涡状纤维化。该病可以累及多个眼部组织或器官,如泪腺、眼外肌、眼眶脂肪以及三叉神经等,其主要临床表现是双侧或单侧眼眶慢性无痛性肿胀、眼球突出,可伴有外周淋巴结肿大,通常视力损害不明显,但严重时可使被累及的组织器官功能丧失而影响患者日常生活。IgG4-ROD的发病机制尚不明确,推测可能与自身抗体产生、微生物感染和基因遗传等因素有关。对于IgG4-ROD的治疗,目前主要是采用糖皮质激素、免疫抑制剂、生物制剂以及手术治疗等,这些治疗方式虽可以取得一定疗效,但存在一定的局限性如高复发率、严重的副作用及术后并发症等。

Abstract: IgG4-related ocular disease ( IgG4-ROD) is a kind of autoimmune disease with a large number of lymphocyte and plasma cell infiltration, obliterative phlebitis and sylvan or whirlpool fibrosis. It can involve many eye tissues or organs, such as lacrimal gland, extraocular muscle, orbital fat and trigeminal nerve. Its main clinical manifestations are chronic painless swelling and / or exophthalmos on both or one side of the orbit, which may be accompanied by peripheral Lymphadenopathy, usually not obvious visual impairment, but serious can make function loss of the involved tissues and organs and affect the daily life of patients. The pathogenesis of IgG4-ROD is not clear. According to the existing literature, it may be related to the production of autoantibodies, microbial infection and genetic factors. For the treatment of IgG4-ROD, at present, glucocorticoids, immunosuppressants, biological agents and surgical treatment are the main clinical methods. Although these treatment methods can achieve certain efficacy, there are certain limitations such as high recurrence rate, serious side effects and postoperative complications.