系统性红斑狼疮眼底病变的特征

目的探讨系统性红斑狼疮（SLE）患者的眼底病变的临床特点。方法回顾性系列病例研究。分析2002-2013年在北京协和医院眼科门诊就诊的36例（57眼）经免疫内科确诊为SLE患者的眼底病变情况。其中男4例，女32例；年龄14~71岁，平均（32.6±11.5）岁。常规用裂隙灯显微镜检查前节、散瞳查眼底、眼底照像及FFA。结果57眼中视网膜血管炎24眼；毛细血管前小动脉闭塞18眼；视网膜大血管阻塞17眼，其中视网膜动脉阻塞10眼，视网膜静脉不全阻塞5眼，视网膜动静脉阻塞2眼；视神经病变6眼，其中视神经乳头炎1眼，球后视神经炎4眼，缺血性视神经病变1眼；巨细胞病毒性视网膜炎3眼。结论SLE的眼底病变主要表现为视网膜血管炎、毛细血管前小动脉闭塞及视网膜大血管阻塞。

Observation of the ocular fundus manifestations of systemic lupus erythematosus

ObjectiveTo describe the manifestations of ocular fundus secondary to systemic lupus erythematosus （SLE）. MethodsThis was a retrospective study. Thirty-six patients （57 eyes） who were diagnosed with SLE by the Department of Rheumatology in Peking Union Medical College Hospital during the years of 2002-2013 were enrolled in the study. These case studies from the Department of Ophthalmology were summarized. The patients included 4 males and 32 females from 14 to 71 years of age with a mean age of 32.6±11.5 years. Ocular anterior segments were examined with a slit lamp microscope. Fundus examinations were performed with papillary dilation， fundus photography and fundus fluorescein angiography. ResultsTwenty-four eyes showed retinal vasculitis. Eighteen eyes showed precapillary arteriole occlusion. Seventeen eyes presented with retinal vascular occlusion， 10 of presented with retinal artery occlusion， 5 presented with retinal vein occlusion， and 2 presented with retinal artery occlusion and vein occlusion. Six eyes presented with optic neuropathy， including 1 eye with neuropapillitis， 4 eyes with retrobulbar neuritis， and 1 eye with ischemic optic neuropathy. Three eyes presented with cytomegalovirus retinitis. ConclusionRetinal vasculitis， precapillary arteriole occlusion and retinal vascular occlusion are the most common manifestations of SLE as part of ocular fundus changes.