结核性葡萄膜炎的研究进展

伴随着结核病的新发病例数逐年增加,结核性葡萄膜炎的发病率也呈不断上升趋势.结核性葡萄膜炎的临床表现多种多样,可表现为前葡萄膜炎、脉络膜结节、多灶性脉络膜炎,少见的有匐行性脉络膜炎、视网膜下脓肿等,也可表现为疑似眼内肿瘤,甚至以黄斑囊样水肿为惟一表现.由于目前尚缺乏合适的诊断标准,临床上极易漏诊、误诊及延迟诊断,常造成患者视力丧失、盲,甚至眼球摘除的严重后果.聚合酶链反应及γ干扰素释放试验等新技术有助于结核性葡萄膜炎的诊断.结核性葡萄膜炎的早期诊断和正确治疗亟需加强.

Recent advances in tuberculous uveitis

With an increasing number of new cases of tuberculosis every year, the incidence of tuberculous uveitis presents a rising trend. The disease is associated with a wide spectrum of clinical manifestations. The common clinical presentations appear to be anterior uveitis, choroidal tubercles,multifocal choroiditis, rarely serpiginous-like choroiditis, subretinal abscesses or suspected ocular tumors.Macular edema can be the only ocular manifestation of tuberculosis. With absence of proper diagnostic standard, it usually leads to missed diagnosis, misdiagnosis, and delayed diagnosis of tuberculous uveitis which can result in severe consequences such as vision loss, blind, and even eye enucleation. New technology such as PCR and Interferon-Gamma release assays can be helpful for the diagnosis of tuberculous uveitis. The early diagnosis and standard treatment of tuberculous uveitis are in urgent need.