狼疮眼部并发症与神经病变……

前沿进展丨狼疮眼部并发症与神经病变、肾病变和死亡率高相关

作者：De Andrade FA. et al
译者：翟佳羽
发布：郭 越 校对：王振青
摘要


系统性红斑狼疮是能够影响不同眼部结构的慢性自身免疫性疾病，如角膜、结膜、巩膜外层、巩膜、葡萄膜、视网膜、视神经和血管。系统性红斑狼疮的神经眼科表现包括不同程度的视网膜、脉络膜和视神经受累。视网膜病变是最常见的眼部受累且用于活动度评估的临床标准。研究证实超过29%活动性系统性红斑狼疮患者表现为视网膜病变。脉络膜疾病的确切发病率尚不清楚，但由于诊断不足被认为较视网膜病变少见。视神经疾病，表现为视神经炎和前/后缺血性视神经病，影响约1%系统性红斑狼疮患者。这些眼部表现与神经病变加重、抗心磷脂抗体、肾脏病变和高死亡率相关。本文目的是回顾系统性红斑狼疮不同神经眼科病变的表现。由于这些表现频繁且有潜在危害，需要多专业团队的恰当诊断和早期提供积极治疗以避免视觉后遗症


END


附原文：

Abstract：

Systemic lupus erythematosus (SLE)is a chronic autoimmune disease that can affect different ocular structures,such as cornea, conjunctiva, episclera, sclera, uveal tract, retina, opticnerve and vessels. Neuro-ophthalmologic manifestations in SLE includedifferent degrees of involvement of retina, choroid and optic nerve.Retinal changes are one of the most common ocular involvements and arefrequently used as clinical criteria for activity, even if isolated. Studiesshow that up to 29% of patients with active SLE manifest retinal disease. Theexact prevalence of choroidal disease is unknown, but is thought to be lesscommon than retinopathy, due to under-diagnosis. Optic nerve disease,represented by optic neuritis and anterior/posteriorischaemic optic neuropathy, affects approximately 1% of SLE patients.These ocular manifestations have been associated with neurologic flares,antiphospholipid antibodies, nephropathy, and increased mortality. The aim ofthis paper is to review the different aspects of neuro-ophthalmologicinvolvement in SLE. Since these manifestations are frequent and potentiallysevere, a multi-professional team approach is needed to investigate properly andprovide early aggressive treatment in order to avoid visual sequelae.








引自：
de Andrade FA, Guimarães Moreira Balbi G, Bortoloti de Azevedo LG, et al. Neuro-ophthalmologic manifestationsin systemic lupus erythematosus. Lupus. 2017 Apr;26(5):522-528. doi:10.1177/0961203316683265.