清开灵治疗葡萄膜炎疗效观察

用清开灵治疗葡萄膜炎共２９例４２眼，其中显效者１７例２６眼，有效者８例９眼，无效者４例７眼，有效率为８３．３％。清开灵治疗眼部葡萄膜炎有如下优点：①病情控制比较好，②与皮质激素有协同作用，③可减少皮质激素用量及其副作用。④副作用少。但疗效作用缓慢，对于炎症重者必须与皮质激素，联合应用才能取得较好的效果。     

感染性葡萄膜炎的诊治观察

目的探讨感染性葡萄膜炎的临床特点及诊治疗效。方法回顾分析2011年8月至2016年9月在十堰市太和医院眼科诊断为感染性葡萄膜炎并接受住院治疗患者的病例资料。结果 18例(19只眼)感染性葡萄膜炎患者,其中急性视网膜坏死综合征8例、弓形虫性葡萄膜炎3例、弓蛔虫性葡萄膜炎1例、弓蛔虫合并弓形虫性葡萄膜炎1例及结核性葡萄膜炎5例。8例急性视网膜坏死综合征分别经过药物治疗或药物联合手术治疗,仅2例患者视力有轻度提高,余病情稳定,但视力无改善。1例弓形虫性葡萄膜炎因延误治疗导致视力降为光感/眼前,另外2例弓形虫性葡萄膜炎患者经过治疗后视力均得到了提高。1例弓蛔虫性葡萄膜炎经过药物治疗后行玻璃体手术,视力由0.5提高到0.6;1例弓蛔虫合并弓形虫性葡萄膜炎经过对症治疗后视力由0.1提高到0.15。结核性葡萄膜炎患者经过抗结核等对症治疗后病情稳定,视力均有不同程度的提高。结论弓形虫、弓蛔虫及结核性葡萄膜炎通常经过正确及时的治疗后,病情稳定,视力有改善。急性视网膜坏死综合征患者通常病情较重,预后相对较差。     

甲基强的松龙冲击疗法治疗原田氏病

原田氏病是侵犯全身各器官的黑色素细胞特异性自身免疫性疾病。本病必须局部使用类固醇并进行扩瞳，但关键在于大剂量类固醇全身给药，以类固醇强大的抗炎及免疫抑制作用抑制急性渗出性炎症，阻止免疫反应发展。为此所需的类固醇量，换算成强的松龙通常为每天200～400mg。本病若早期开始治疗则预后较好，但部分病例对类固醇耐药使疾病迁延不愈，也有少数病例停药后复发。为了提高疗效，减少复发，作者于近几年采用超大剂量甲基强的松龙冲击疗法治疗本病，取得了良好疗效。对象和方法一、对象：原田氏病患者4例，男性2例，女性2例，发病半月…     

鼠神经生长因子联合甲基强的松龙治疗AON的疗效

目的:观察鼠神经生长因子联合甲基强的松龙治疗急性视神经炎(AON)的效果。方法:对1999-03/2011-03在我院治疗的55例65眼AON患者的病案资料进行回顾性分析。结果:治疗组有效率为90.6%,对照组有效率为69.7%。治疗组疗效优于对照组(P<0.05)。结论:鼠神经生长因子联合甲基强的松龙治疗AON有较好的疗效。     

Intravenous pulse methylprednisolone in the treatment of uveitis associated with multiple sclerosis

Purpose : To demonstrate the safety and effectiveness of intravenous methylprednisolone (IVMP) in the treatment of uveitis in association with multiple sclerosis (MS). Methods : Uveitis is an unusual manifestation of MS that may be severe, chronic and require systemic immunosuppression therapy. High‐dose IVMP has previously been shown to be effective in the treatment of inflammatory eye disease and MS. Eight episodes of uveitis in five patients with MS were treated over a 10‐year period in an open, uncontrolled trial. Two patients had chronic anterior uveitis, one patient had bilateral panuveitis and two patients had intermediate uveitis. Results : All patients responded to IVMP with evidence of a decrease in intraocular inflammatory activity and improved visual acuity (VA) within 2 weeks of commencing treatment. There were no severe ocular or systemic steroid side effects. Conclusions : Intravenous methylprednisolone is an effective, well‐tolerated form of therapy for uveitis in patients with MS.     

中间型葡萄膜炎并发复杂性视网膜脱离的玻璃体手术治疗

目的:探讨中间型葡萄膜炎并发复杂性视网膜脱离的临床特征及玻璃体切除联合眼内填充术的治疗效果。方法:回顾性分析我院2000-01/2005-06收治的11例(共11眼)中间型葡萄膜炎并发复杂性视网膜脱离病例术前及术后详细的临床资料。所有患者均接受巩膜外环扎,玻璃体切除联合眼内填充术治疗,术中9眼行硅油充填,2眼填充长效惰性气体。术后随访12～66mo。结果:术后11眼均获视网膜良好复位及视力增进。随访期中有7眼于6～12mo取出硅油,硅油取出后2眼因周边部PVR或葡萄膜炎复发导致视网膜脱离复发,未取硅油的4眼(包括2只再手术眼)视网膜平伏。结论:中间型葡萄膜炎并发的复杂性视网膜脱离,尤其存在周边部纤维及血管膜的牵引时,玻璃体切除联合眼内填充术效果确切,周边部PVR和葡萄膜炎复发是术后限制视网膜复位的主要原因。     

非感染性葡萄膜炎的系统治疗进展

葡萄膜炎是发生于眼内组织的炎症反应。其中,非感染性葡萄膜炎是T细胞介导的自身免疫性炎症反应。尽管非感染性葡萄膜炎的系统治疗方案多种多样,但主要原理都是抑制自身免疫反应。在本综述中,我们回顾了非感染性葡萄膜炎系统治疗的历史,详细叙述了系统治疗的现状,总结了各治疗方案的利弊,同时对非感染性葡萄膜炎的系统治疗进行一定的展望。     

FK506的免疫抑制作用及其在葡萄膜炎治疗中的应用

ＦＫ５０６是一种强效的免疫抑制剂,通过抑制钙神经素的活性抑制白细胞介素２（ＩＬ－２）等细胞因子的基因表达,从而发挥免疫抑制作用。动物实验表明ＦＫ５０６能够预防实验性自身免疫性葡萄膜视网膜炎（ＥＡＵ）的发生或者降低其严重程度。临床治疗证明了ＦＫ５０６对葡萄膜炎,尤其是顽固性内源性葡萄膜炎有较好的治疗效果。副作用主要有肾毒性、胃肠道症状和神经毒性等。通过选择合适的适应证、使用适当的剂量和监测ＦＫ５０６的血药质量浓度,可以取得较好的治疗效果并避免一些副作用的发生。     

Pharmacologically induced uveitis

Treatments of numerous systemic and local diseases of different etiologies may be accompanied by an unwanted side effect in the form of uveitis. We inform readers about medications that have the potential to cause uveitis and analyze the strength of association of these medications with uveitis. Subsequently, cessation of medication or appropriate treatment can be individualized for each patient for the purpose of preventing further damage to tissue structure and function. Being aware of these associations, physicians may readily identify medications that may cause uveitis and avoid expensive and unnecessary clinical and laboratory testing.     

Diagnosing the systemic associations of anterior uveitis

Up to one-half of patients with anterior uveitis suffer from related systemic diseases. The common associations are the seronegative arthropathies and, in children, juvenile chronic arthritis. Anterior uveitis may also occur in the context of sarcoidosis or Behçet's disease. Syphilis and tuberculosis remain a significant problem for specific populations and may be the cause of anterior uveitis in these groups. By thorough clinical history and the correct selection and interpretation of simple investigations, it is generally possible for the ophthalmologist to make or exclude a systemic diagnosis, predict the ocular prognosis and direct selected patients to the appropriate physician. Diseases that threaten the patient's wellbeing must certainly be recognized. In the present review we present a method for identifying the systemic associations of anterior uveitis.     

合理应用糖皮质激素治疗急性前葡萄膜炎

目的:探讨急性前葡萄膜炎糖皮质激素应用的合理方法。方法:对65例72眼急性前葡萄膜炎患者使用糖皮质激素局部频繁点眼治疗,观察其疗效。结果:所有患者均能很快控制病情并治愈,治愈时间5～35(平均约12)d。论:对绝大多数急性前葡萄膜炎患者仅用糖皮质激素、甾体消炎药和睫状体麻痹剂点眼即能治愈炎症。