130例葡萄膜炎的临床分析

对我国西北地区130例葡萄膜炎患者的临床资料进行了分析，发现20~50岁的患者占82.3%.按解剖位置进行分类，前葡萄膜炎是最常见的类型，占86.15%；中间、全和后葡萄膜炎所占比例较少，分别占6.92%、3.85%和3.08%。葡萄膜炎最常见的病因和伴随的疾病是风湿性关节炎。根据我们分析的结果讨论了有关问题。 （中华眼底病杂志，1994，10：156-158）     

儿童葡萄膜炎临床分析

目的 分析儿童葡萄膜炎的临床特点、治疗效果、视力预后以及相关的全身疾病.方法 采用回顾性病例分析方法,收集近4年间在天津市眼科医院诊治的16周岁及以下的儿童葡萄膜炎患者106例(165只眼),通过详细询问病史、眼部或全身检查,确定葡萄膜炎类型;分析其治疗效果、并发症发生情况和视力预后.结果 在106例患者中,男45例,女61例(1:1.4);平均发病年龄为(10.9±3.3)岁.急性发病18例(17.0%),慢性发病37例(34.9%),反复发作者51例(48.1%).单眼发病47例,双眼发病59例.其中前葡萄膜炎52例(49.1%),中间葡萄膜炎31例(29.2%)、全葡萄膜炎15例(14.2%)和后匍萄膜炎8例(7.5%).感染性葡萄膜炎15例(14.2%),特发性或免疫相关性炎症91例(85.8%).根据病因分类,特发性前葡萄膜炎36例(34.0%),特发性中间葡萄膜炎31例(29.2%),特发性全葡萄膜炎13例(12.3%),合并幼年型关节炎10例(9.4%)和病毒性前葡萄膜炎5例(4.7%).42例患儿58只跟(35.2%)出现眼部并发症,主要有虹膜后粘连(21.8%)、并发白内障(17.0%)、继发青光眼(9.7%)、角膜带状变性(9.7%)和黄斑囊样水肿(8.5%).末次随访矫正视力低于0.5者45只眼(27.3%),低于0.1者16只眼(9.7%).结论 前葡萄膜炎是儿童时期常见的葡萄膜炎类型,其次为中间葡萄膜炎和全葡萄膜炎,后部葡萄膜炎较少见.多数患者表现为慢性特发性炎症,感染性葡萄膜炎较少见.儿童葡萄膜炎引发的各类并发症是致盲的主要原因.     

不同类型葡萄膜炎患者致病原因分析

目的：分析不同类型葡萄膜炎患者的致病原因。
　　方法：选取2012-06/2015-06在我院进行诊治的葡萄膜炎患者60例120眼,所有患者均由同一葡萄膜炎专科医生,按照统一诊疗规范进行检查。依据国际葡萄膜炎研究定制的标准,将其分为：前葡萄膜炎、中葡萄膜炎、后葡萄膜炎、全葡萄膜炎。观察患者的年龄、性别、葡萄膜炎类型及患病原因。
　　结果：通过对患者的病因及临床类型分析,所选葡萄膜炎患者主要特发性26眼(21.7%)、VKH 综合征18眼(15.0%)、HLA-B27相关性14眼(11.7%)、病毒性12眼(10.0%)、Fuchs 综合征8眼(6.7%)、Behcet 病8眼(6.7%)、糖尿病6眼(5.0%)、梅毒6眼(5.0%)、青光眼睫状体综合症6眼(5.0%)、幼年型慢性关节炎4眼(3.3%)、交感性眼炎4眼(3.3%)、外伤性2眼(1.7%)、类肉瘤2眼(1.7%)、眼内炎2眼(1.7%)、其他2眼(1.7%);通过对不同葡萄膜炎的病因观察,前葡萄膜炎病因主要有特发性病例,其次是HLA-B27相关性、病毒性;全葡萄膜炎的治病原因中以VKH综合征、特发性病例和Behcet病为主;后葡萄膜炎主要是特发性病例,其次是病毒性感染;中间葡萄膜炎以特发性病例为主。
　　结论：通过对临床患者观察分析,葡萄膜炎患者男性多于女性;特发性、VKH 综合征、病毒性伴发的葡萄膜炎和Behcet病是其常见的葡萄膜炎类型。     

非感染性葡萄膜炎343例患者的分型、临床表现及并发症

目的　探讨非感染性葡萄膜炎患者的分型、临床表现及并发症。方法　选取2016年5月至2018年2月就诊于中山大学中山眼科中心葡萄膜炎专科并确诊为非感染性葡萄膜炎的患者343例（630眼）病历资料。记录入组患者一般资料,对患者进行详细的眼部检查。非感染性葡萄膜炎的诊断及分型参照2005年葡萄膜炎命名标准化工作组提出的相关标准。总结343例非感染性葡萄膜炎患者的分型、临床表现及并发症。结果　343例（630眼）非感染性葡萄膜炎患者中,56例单眼受累,287例双眼受累;男女比例为1.4∶1.0;发病年龄为21～50（36.3±12.4）岁。无明确病因的特发性患者122例,已明确病因患者221例,以Behcet病（30.3%）和VKH综合征（20.7%）最常见。343例非感染性葡萄膜炎患者按照炎症发生或累及的解剖部位分类,全葡萄膜炎（177/343,51.6%）占比最多,其他依次为中间葡萄膜炎（72/343,21.0%）、后葡萄膜炎（53/343,15.4%）、前葡萄膜炎（41/343,12.0%）。104例Behcet病性葡萄膜炎患者中出现复发性口腔溃疡91例、结节性红斑37例。71例VKH综合征性葡萄膜炎患者出现耳鸣39例、皮肤及毛发异常11例、头皮痛或感觉异常9例。343例非感染性葡萄膜炎患者眼部并发症以白内障（228例）最为常见,其次分别是视神经萎缩（39例）、黄斑萎缩（38例）和继发性青光眼（36例）。结论　非感染性葡萄膜炎患者中,全葡萄膜炎的发生率高于前葡萄膜炎;Behcet病性葡萄膜炎和VKH综合征性葡萄膜炎仍是我国最常见的全葡萄膜炎类型。     

葡萄膜炎致盲目特点及原因探讨

目的 探讨我国常见类型葡萄膜炎的致盲特点与主要致盲原因。 方法 回顾分析1 214例各种类型葡萄膜炎患者的临床资料，着重分析各种葡萄膜炎中常见的致盲类型及致盲原因。 结果 1214例患者1892只患眼中，355只患眼致盲，占18.76%。致盲时平均年龄34.38岁，男女比例为1.52∶1。全葡萄膜炎致盲248只眼，占此类患眼的26.27%，其中，Behcet病和Vogt-小柳原田(VKH)综合征致盲者分别占51.61%和29.44%。全葡萄膜炎致盲者中，主要原因为并发性白内障，共89只眼，占35.89%；玻璃体混浊53只眼，占21.37%；继发性青光眼30只眼，占12.10%。前葡萄膜炎致盲79只眼，占此类患眼的10.73%，主要致盲原因为并发性白内障，共56只眼，占70.89%；继发性青光眼16只眼，占20.25%。后葡萄膜炎致盲15只眼，占此类患眼的15.63%，主要致盲原因为玻璃体混浊，共9只眼，占此类患眼的60.00%；黄斑病变3只眼，占此类患眼的20.00%。中间葡萄膜炎致盲13只眼，占此类患眼的11.21%，主要致盲原因为玻璃体混浊，共8只眼，占61.54%；并发性白内障5只眼，占38.46%。 结论 葡萄膜炎具有致盲率高及盲目主要发生于青壮年等特点；全葡萄膜炎，特别是Behcet病和VKH综合征是我国葡萄膜炎中最重要的致盲类型；并发性白内障、继发性青光眼等并发症是葡萄膜炎致盲的主要原因。 (中华眼底病杂志, 2005, 21: 350-352)     

102例少年儿童葡萄膜炎临床分析

目的 观察分析少年儿童葡萄膜炎的病程、病因及并发症.方法 回顾分析102例少年儿童葡萄膜炎患者的临床资料.患儿年龄2.5～16.0岁,平均年龄11.9岁.均进行常规视力、裂隙灯显微镜、检眼镜检查以及相关实验室检查.根据国际葡萄膜炎研究组制定的根据解削位置分类的标准对疾病进行诊断、分类.回顾分析时,对患者发病眼别、复发情况、炎症部位、病因、并发症等临床资料进行归纳比较.结果 102例葡萄膜炎患儿共170只眼受累,双眼受累68例,占66.6%.前葡萄膜炎38例,占37.3%;中间葡萄膜炎19例,占18.6%;后葡萄膜炎10例,占9.8%;全葡萄膜炎35例,占34.3%.发病至就诊时间为5 d～2.4年,平均发病时间3.6个月,治疗及随访时间为2周～10余年.病因前3位为幼年慢性关节炎、Vogt-Koyanagi Harada综合征、Behcet病.36例患儿发生并发症,包括并发性白内障19例,继发性青光眼7例,角膜带状变性5例,虹膜前后粘连12例,继发性视网膜脱离1例,眼球萎缩2例.因幼年慢性关节炎全身和局部使用糖皮质激素出现双侧股骨头坏死而行双髋关节置换1例.有10例患儿出现2种以上并发症.结论 少年儿童葡萄膜炎病因复杂多样,症状多不典型,疾病过程迁延慢长,易出现并发症导致盲目产生.     

1100例葡萄膜炎临床分析

本文对１１００例葡萄膜炎患者的临床资料进行分析，按病变解剖位置分类，以前葡萄膜炎例数最多５４７例，占４９．７３％，全葡萄膜炎次之４１１例，占３７．３６％，中间葡萄膜炎１３２例，占１２．０％，而后葡萄炎只有１０例，占０．９１％。根据病史，临床表现，合并全身疾病及有关实验室检查，对患者病因进行分析。能确定病因及特殊类型的有５５３例，占５０．２７％，常见的类型是：小柳－原田氏病（ＶＫＨ综合征２２５例，２０．４５％），风湿性关节炎（１４９例，１３．５５％），Ｂｅｈｃｅｔ病（６７例，６．０９％），单疱病毒感染（３６例，３．２７％）和Ｆｕｃｈｓ综合征（２３例，２．０９％）。     

前葡萄膜炎的临床诊治分析

目的 探讨前葡萄膜炎的临床特点、治疗效果、视力预后及诊治中存在的问题.方法 回顾性系列病例研究.收集2001年1月至2007年6月期间在天津市眼科医院诊治的各类前葡萄膜炎患者478例,男性281例,女性197例;平均发病年龄(36±15)岁.通过详细临床检查、实验室检查和治疗观察,对其临床类型、疗效、并发症及视力预后进行分析.结果 急性前葡萄膜炎242例(50.6%),复发性前葡萄膜炎197例(41.2%),慢性前葡萄膜炎39例(8.2%).依据病因分为特发性前葡萄膜炎231例(48.3%),不伴有全身疾病的人类白细胞抗原-B27阳性葡萄膜炎76例(15.9%),病毒性葡萄膜炎52例(10.9%),合并强直性脊柱炎34例(7.1%),Fuchs综合征29例(6.1%),青光眼睫状体炎综合征24例(5.0%)及幼年性关节炎合并葡萄膜炎17例(3.6%).各种并发症发生率为31.6%(151例),轻度视力损害(低于0.5)发生率为11.1%(53例),中度和重度视力损害(低于0.3)为7.5%(36例),致肓率(低于0.05)为2.5%(12例).结论 前葡萄膜炎临床类型多样,特发性前葡萄膜炎、人类白细胞抗原-B27相关性前葡萄膜炎及病毒性前葡萄膜炎是常见类型,完善特异性实验室检查项目有助于病因诊断和给予适当治疗.     

全葡萄膜炎的临床特征及诊治分析

目的 探讨全葡萄膜炎的临床特征及治疗.方法 回顾分析2011年8月至2013年6月我院眼科诊断为全葡萄膜炎并接受住院治疗患者的病例资料.结果 26例（32只眼）全葡萄膜炎患者中,男性17例,女性9例,男女比例为1.89：1,平均年龄为（40.1±12.1）岁.其中特发性10例（42.1%）,小柳原田综合征4例（15.4%）,交感性眼炎3例（11.5%）,病毒性3例（11.5%）,Behcet病2例（7.7%）,急性视网膜坏死综合征2例（7.7%）,强直性脊柱炎1例（3.85%）和尘肺伴肺结核1例（3.85%）.经局部糖皮质激素、非甾体药物、睫状肌麻痹剂,全身糖皮质激素甚至免疫抑制剂,以及抗病毒及抗结核,多数全葡萄膜炎患者视力得到改善.结论 全葡萄膜炎对视力损害严重,治疗周期较长,不及时、合理的治疗常常导致盲目的 发生,短期的住院治疗仅使患者炎症得以部分控制,炎症的彻底控制仍需较长时间的药物维持;同时全葡萄膜炎的病因复杂,给眼科医生正确诊断和治疗带来了困难.     

关注我国葡萄膜炎的病因和类型的变化

本文旨在阐述我国葡萄膜炎的常见类型、主要致盲类型及新近出现或增多的一些类型,指出Vogt-小柳原田综合征和Beh(c)et病是我国常见的葡萄膜炎主要致盲类型,梅毒、结核、真菌性葡萄膜炎或眼内炎的发病逐渐增多,艾滋病所致的机会性感染尤其是巨细胞病毒性视网膜炎呈现上升的发病趋势,眼内-中枢神经系统淋巴瘤、视网膜母细胞瘤及恶性肿瘤眼内转移所致的伪装综合征的发生也有所增加.     

中國葡萄膜炎的臨床類型及病因學

目的探討及分析中國葡萄膜炎患者的臨床及病因分型.方法回顾性分析了中山眼科中心葡萄膜炎診室接診的1200例(男性690例,女性510例)葡萄膜炎患者.根據解剖特點進行了臨床分型.從病史,臨床表现及實驗室檢查方面進行了病因分型.結果在1200例中,601例(50.%)屬前葡萄膜炎,454例(37.8%)屬全葡萄膜炎,1 34例(11.2%)屬中間葡萄膜炎,11例(0.9%)屬後葡萄膜炎.病因查明者有616例(51.4%),包括伏格特-小柳-原田綜合癥(252例,21.0%),風濕性關節炎(156例,13.0%),白塞氏病(78例,6.5%),單純疱疹病毒感染(40例,3.3%),富克斯异色性睫状體炎(25例,2.1%)及其它.結論前葡萄膜炎,伏格特-小柳-原田综合癥前葡萄膜炎,風濕性關節炎前葡萄膜炎及白塞氏病前葡萄膜炎分别是中國最常見的解剖或病因類型.     

中国葡萄膜炎的临床类型及病因学(英文)

目的 探讨及分析中国葡萄膜炎患者的临床及病因分型 方法 回顾性分析了中山眼科中心葡萄膜炎诊室接诊的1200例(男性690例,女性510例)葡萄膜炎患者 根据解剖特点进行了临床分型 从病史,临床表现及实验室检查方面进行了病因分型 结果在1200例中,601例(50.1％)属前葡萄膜炎,454例(37.8％)属全葡萄膜炎,134例(11.2％)属中间葡萄膜炎,11例(0.9％)属后葡萄膜炎 病因查明者有616例(51.4％),包括伏格特— 小柳—原田综合瘙(252例,21.0％)。风湿性关节炎(156例,13.0％),白塞氏病(78例,6.5％),单纯疱疹病毒感染(40例,3.3％),富克斯异色性睫状体炎(25例,2.1％)及其它,结论 前葡萄膜炎,伏格物—小柳—原田综合症前葡萄膜炎,风湿性关节炎前葡萄膜炎及白塞氏病前葡萄膜炎分别是中国最见的解剖或病因类型。     

Clinical patterns and characteristics of uveitis in a tertiary center for uveitis in China

PURPOSE: To address the clinical pattern and characteristics of uveitis in a tertiary center for uveitis in China and compare the similarity and difference in the distribution of uveitis entities between China and other countries. METHODS: A retrospective study was performed on the patients with uveitis referred to the Zhongshan Ophthalmic Center from January 1996 to December 2003. The clinical data including category, etiology, gender, and the age of the patients at uveitis presentation were analyzed and compared with studies published previously from other countries. RESULTS: There were 902 male and 850 female patients in our series. The mean age of these patients at uveitis presentation was 33.8 +/- 16.5 years. Anterior uveitis (800, 45.6%) was the most common anatomical entity, followed by panuveitis (727, 41.5%), posterior uveitis (119, 6.8%), and intermediate uveitis (106, 6.1%). Further classification with the etiology criteria revealed 16 entities in anterior uveitis, with idiopathic anterior uveitis being the most common entity (473, 27.0%). Twelve entities were identified in panuveitis, of which Beh?et disease (289, 16.5%) and Vogt-Koyanagi-Harada (VKH) syndrome (278, 15.9%) were the predominant ones. No specific entity was recognized in the intermediate uveitis group. Although a number of specific entities were identified in posterior uveitis, toxoplasmosis was noted in only two patients in this group. CONCLUSIONS: Idiopathic anterior uveitis, Beh?et disease, and VKH syndrome are the most common entities of uveitis in China. Ocular toxoplasmosis, ocular histoplasmosis, and birdshot retinochoroidopathy are less common or absent in China.     

白塞综合征葡萄膜炎临床特点分析

目的总结白塞综合征葡萄膜炎(BU)的临床特点。方法回顾性系列病例研究。收集1998年1月至2015年11月就诊于北京协和医院眼科葡萄膜炎专业组的BU患者,整理临床资料。总结BU的临床表现、并发症、最佳矫正视力(最小分辨角对数视力)及药物治疗方案。分析不同病程视力变化情况及生物制剂治疗前后BU复发次数。应用χ2检验及Wilcoxon符号秩检验进行统计学分析。结果共纳入132例(233只眼)BU患者,其中男性104例(78.8%),女性28例(21.2%),性别分布差异有统计学意义(χ2=43.76,P<0.01)。BU发病年龄为(28.9±8.7)岁,主要集中在21~40岁(102例,77.3%)。口腔溃疡(132例,100.0%)、皮肤病变(103例,78.0%)、外阴溃疡(90例,68.2%)、关节受累(44例,33.3%)及针刺反应阳性(39例,29.5%)为BU前5位眼外表现。患者常双眼受累(101例,76.5%),全葡萄膜炎(110例,83.3%)为最主要的葡萄膜炎类型。共188只眼(80.7%)出现并发症,最常见的眼前、后节并发症分别为并发性白内障(58.8%,137/233)及黄斑水肿(59.1%,114/193)。病程前8年,患者视力呈下降趋势;在病程第8年,20.9%(9/43)的患眼最佳矫正视力<0.3,39.5%(17/43)的患眼最佳矫正视力>1.0。97.0%(128/132)的患者接受糖皮质激素联合免疫抑制剂治疗。16例顽固性BU加用生物制剂(肿瘤坏死因子拮抗剂或干扰素α)后BU复发频次显著减少,由4.0(1.0,5.5)次/年降至0.5(0.0,1.5)次/年,差异有统计学意义(Z=-2.81,P=0.005)。结论BU在青壮年男性中多见,常累及双眼,主要表现为全葡萄膜炎。患者眼部并发症极为常见,视力严重受损。糖皮质激素联合免疫抑制剂在多数情况下可控制眼内炎性反应,但对于顽固性葡萄膜炎,生物制剂的应用取得较好疗效。     

Patterns of uveitis in a tertiary eye care center in Iran

Purpose: To identify the distribution and characteristics of new uveitis referrals to a tertiary eye care center in Tehran. Methods: A three-year prospective study was carried out to obtain information on 544 new patients referred with uveitis. A complete ophthalmologic examination was performed in all cases; a routine set of tests and an additional battery of directed workup were conducted when indicated. Results: Mean age was 32.3 years. There was no significant sex predominance. The most common forms of uveitis were anterior (38.4%) vs. other anatomical forms, chronic (62.1%) vs. acute (28.3%), nongranulomatous (85.5%) vs. granulomatous (14.5%), and noninfectious (83.5%) vs. infectious (16.5%). With regard to etiology, 45.5% were idiopathic, 19.9% were due to specific ocular disease, and 37.3% were associated with systemic disorders. Behçet's disease was the most common noninfectious disease and toxoplasmosis the most common infectious entity. The most prevalent causes were idiopathic, Fuchs' heterochromic iridocylitis, and seronegative spondyloarthropathies in anterior uveitis; toxoplasmosis, Eales disease, and toxocariasis in posterior uveitis; idiopathic, sarcoidosis, and multiple sclerosis in intermediate uveitis; and, finally, Behçet's disease, idiopathic, and Vogt-Koyanagi-Harada syndrome in panuveitis. The most frequent cause in patients under 16 years of age was pars planitis. Over 80% of the patients belonged to middle-to-upper socioeconomic classes. Uveitis significantly affected patients' lives in 63.1% of the cases. Conclusion: Although the current study was performed at a referral center, it may reflect to some extent the different distribution of uveitis in Iran and probably other Middle Eastern countries. Some entities such as presumed ocular histoplasmosis were not found, cytomegalovirus retinitis and birdshot chorioretinopathy were extremely rare, and HLA-B27-associated iridocyclitis was less commonly observed. In contrast, Behçet's disease, Fuchs' heterochromic iridocyclitis, Eales disease, and toxocariasis were among the more prevalent entities.     

Pattern of uveitis in a referral uveitis clinic in India

This report describes a retrospective study of all new patients in our uveitis clinic between January 1992 and December 1994, undertaken to identify the pattern of uveitis in the Indian subcontinent. A standard clinical protocol, and the naming-meshing system with tailored laboratory investigations were used to arrive at a final uveitic diagnosis. Uveitis comprised 1.5% of new cases seen at the centre. Out of 1273 uveitis cases, anterior uveitis was the most common type (39.28%), followed by posterior uveitis (28.75%), intermediate uveitis (17.44%), and panuveitis (14.53%). The most commonly affected age group were patients in their forties (23.57%). Uveitis was less common in children below 10 years (3.61%) and in adults over 60 years of age (6.44%). Men (62.21%) were more commonly affected than women (37.79%). Aetiology remained undetermined in 59.31% of cases. Anterior uveitis was most commonly idiopathic (58.6%). The most common cause of posterior uveitis was toxoplasmosis (27.87%), and that of panuveitis was the Vogt-Koyanagi-Harada syndrome (21.08%). A higher incidence of microbiologically proven tubercular uveitis (5 cases), and uveitis due to live intraocular nematode (4 cases), and malaria (1 case), were seen, in contrast to other studies. Only 2 cases of AIDS with ocular lesions were seen. This paper reveals the pattern of uveitis seen at a major referral eye institute in India.Presented at the McGill Symposium on Uveitis, Montreal, Canada on 12 May 1995     

Etiology of posterior uveitis and panuveitis at the Central University Hospital in Monastir

The authors conducted a retrospective analysis of 245 patients with posterior uveitis or panuveitis in order to determine their etiologies and collect some epidemiological data. A specific diagnosis was made in 80.4%. Behcet's disease (22.4%), toxoplasmosis (22%), and Vogt-Koyanagi-Harada syndrome (9%) were the most common causes of posterior uveitis or panuveitis. No case of confirmed sarco?dosis was found in our series.     

Clinical patterns and characteristics of uveitis in a secondary hospital in southern China

AIM: To investigate the characteristics of uveitis in a secondary hospital in southern China. METHODS: We reviewed all records of patients with uveitis at Hengli Hospital from January 2008 to December 2011. Demographic data, past history, ophthalmic examinations and other laboratory tests were analyzed. RESULTS: One hundred and ninety-nine uveitis patients were enrolled in this study, including 134 (67.3%) males and 65 females (32.7%) with an average age of 41.0±15.1y. The anatomical distribution included 103 (51.8%) cases of anterior uveitis, followed by panuveitis (65, 32.7%), posterior uveitis (29, 14.6%) and intermediate uveitis (2, 1.0%). Of the 98 (49.2%) non-idiopathic cases, there were 10.1% Behcet’s disease, 9.5% Vogt-Koyanagi-Harada (VKH) syndrome, 7.5%infectious uveitis, 7.5% traumatic uveitis and 3.5% postoperative uveitis. CONCLUSION: Idiopathic anterior and posterior uveitis, Behcet’s disease, VKH syndrome, infectious uveitis and traumatic uveitis are the most common uveitis entities in a secondary hospital in southern China. Additional measures should be taken to prevent infectious and traumatic uveitis.