13例硬皮病眼部表现临床分析

目的 探讨硬皮病有眼部表现患者的临床特点。设计 回顾性病例系列。研究对象 2008年12月至2013年2月北京同仁医院风湿免疫科住院的13例伴眼部受累硬皮病患者。方法 回顾性分析13例累及眼部的硬皮病患者的临床资料，总结该病临床及实验室特点。主要指标 硬皮病患者的各种眼部表现占总病例数的百分比。结果 13例硬皮病患者均为女性；眼部受累的平均发病年龄为（43±12.2）岁，硬皮病平均病程（6.1±5.1）年，眼病平均病程（1.4±1.9）年。系统型硬皮病11例（84.6%）；局限型硬皮病2例（15.4%）。以眼部症状为首发表现者7例（53.8%）。干燥性角结膜炎7例（53.8%），眼睑皮肤改变3例（23.1%）和青光眼3例（23.1%）为常见眼部表现；其他表现依次为视神经炎、角膜炎、虹睫炎（各2例，占15.4%），巩膜炎、白内障、葡萄膜炎、中心性浆液性脉络膜视网膜病变、眼球内陷、泪腺炎（各1例，占7.7%)。未发现眼部受累与全身表现及实验室指标相关。结论 各型硬皮病均可出现眼部受累，其中以系统型硬皮病为主。硬皮病眼部表现多样，受累范围广泛，其中以干燥性角结膜炎最常见。（眼科， 2015, 24： 317-319， 360）

Clinical study of 13 cases of scleroderma with ocular manifestations

Objective To investigate the clinical features of scleroderma patients with ocular manifestations. Design Retrospective case series. Participants 13 scleroderma patients with ocular involvement were enrolled. Methods The clinical features, laboratory investigation and ocular manifestations of 13 cases of scleroderma with eye affected were retrospectively analyzed. Main Outcome Measures Ocular manifestations. Results All of the 13 cases were female with the mean age of (43±12.2 years). The mean disease duration of scleroderma was 6.1±5.1 years. The mean disease duration of eye involvement was 1.4±1.9 years. System sclerosis 11 cases(84.6%) and localized sclerosis 2 cases(15.4%) were included. Ocular manifestations in the 53.8% (7/13) cases were the primary manifestations. The most common ocular manifestations were kerato-conjunctivitis sicca 7 cases (53.8%), and skin change of the eyelid, glaucoma 3 cases for each(23.1%)，followed by optic neuritis，keratitis，anterior uveitis 2 cases for each（15.4%）; scleritis, cataract, uveitis, central serous chorioretinopathy, enophthalmos and dacryadenitis 1 case for each (7.7%). No association between ocular manifestation and clinical as well as laboratory findings was found. Conclusion Almost any part of the eye with diverse manifestation could be involved in any type of scleroderma. Kerato-conjunctivitis sicca is the most common ocular manifestation of scleroderma. (Ophthalmol CHN, 2015, 24: 317-319, 360)