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)

Characteristics and reasons of blindness induced by uveitis

Objective To investigate the features and main reasons of blindness induced by uveitis in China. Methods A retrospective analysis was performed on the data from 1 214 patients with uveitis, referring to Zhongshan Ophthalmic Center, with special respect to the incidence of blindness in different uveitis entities, the characteristics of blindness, and possible causes for the blindness. Results In the affected 1 892 eyes of 1 214 patients with uveitis, 355 eyes (18.83%) were blind. The mean age at the onset of blindness was 34.38 years and the gender ratio of male to female was 1.52:1. The blindness led by panuveitis was found in 248 eyes (26.27%), including 128 (51.61%) and 73 (29.44%) blind eyes caused by Behcet's disease and Vogt-Koyanagi-Harada syndrome. Complicated cataract, vitreous opacity and secondary glaucoma were responsible for the blindness of the patients with panuveitis [89(35.89%), 53 (21.37%), and 30 eyes (12.10%), respectively]. Blindness caused by anterior uveitis was noted in 79 eyes (10.73%) with the main reasons of complicated cataract [56 eyes (70.89%)] and secondary glaucoma [16 eyes (20.25%)], posterior uveitis in 15 eyes (15.63%) with the main reason of vitreous opacity [9 eyes (60.00%)], macular diseases in 3 eyes (20.00%), intermediate uveitis in 13 eyes (11.21%) with the main reasons of vitreous opacity [8 eyes (61.54%)], and complicated cataract in 5 eyes (38.46%). Conclusions Uveitis is one of the important causes leading to blindness, especially in the young adults. Panuveitis, especially Behcet's disease and Vogt-Koyanagi-Harada syndrome, are the most common entities responsible for blindness in patients with uveitis. Complicated cataract and secondary glaucoma are the main causes of blindness in uveitis.