自身免疫性疾病的眼部病理特征

M. Lukashenko, N. Basantsova, A. Shishkin
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摘要

近年来,自身免疫性疾病的眼科并发症发生率稳步上升,同时全球自身免疫性疾病的数量也在不断增加,新的诊断方法也在不断涌现。据世卫组织估计,2010年视力障碍患者人数估计为2.85亿人,造成3900万例失明。在自身免疫性疾病中,糖尿病、结节病和白塞氏病最常并发这些疾病。干眼综合征是与这些疾病相关的最常见的眼部并发症。我们的目的是描述1型糖尿病、结节病和白塞氏病的眼部并发症,并表明该领域研究的重要性,并制定眼科疾病患者护理的共同标准。本文综述了自身免疫性疾病眼部病变的主要发病联系、种族和遗传因素、及时诊断的主要问题以及各种保守治疗方案的使用。通过对文献的分析得出的结果表明,诸如1型糖尿病、结节病和白塞病等疾病的葡萄膜炎和干眼综合征等眼病可能具有自身免疫性。尽管研究正在进行,但在发病机制和治疗策略的研究中仍有许多未解决的问题。因此,自身免疫性眼病的治疗是一项艰巨的任务,包括对潜在疾病的治疗和视觉器官的局部治疗。由于上述自身免疫性疾病的原发免疫病理有待进一步研究,目前尚无法准确预测眼病的病程、可能的并发症和转归。目前,对于自身免疫性疾病中葡萄膜炎和干眼综合征的统一治疗标准,只有很少的信息。它们的进一步发展有助于建立医疗保健原则,以提高治疗效率和患者的生活质量。这一领域需要进一步的研究和数据积累。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Features of ophthalmic pathology in autoimmune diseases
Incidence of the ophthalmic complications in autoimmune diseases is stably increasing over recent years, as well as overall increase in the number of autoimmune pathologies around the world, along with novel diagnostic approaches. According to the WHO estimates, the number of patients with visual impairment is estimated at 285 million people for 2010, causing blindness in 39 million cases. Among autoimmune diseases, diabetes mellitus, sarcoidosis and Behcet’s disease are most often complicated by these conditions. Dry eye syndrome is the most common eye complication associated with these diseases. Our aim was to describe eye complications in type I diabetes, sarcoidosis, and Behcet’s disease, as well as show the importance of research in the area, and to develop common criteria for the care of patients with ophthalmic conditions. The review considers main pathogenetic links, ethnic and genetic factors of ocular pathologies in autoimmune disorders, the main issues of timely diagnosis and the use of various schemes of conservative therapy. The results obtained upon analysis of the literature contain demonstrate the possible autoimmune nature of such eye pathologies, as uveitis and dry eye syndrome in diseases such as type 1 diabetes mellitus, sarcoidosis, and Behcet’s disease. Despite the ongoing research, there are many unresolved issues in the study of pathogenesis, as well as in therapeutic strategy. Therefore, the treatment of autoimmune eye diseases is a difficult task today, including treatment of the underlying disease, and local therapy of the visual organ. Since the primary immunopathology in the mentioned autoimmune diseases requires further studies, it is not possible to accurately predict the course of eye disease, possible complications and outcomes at the present time. Currently, there is only scarce information for creating uniform criteria for the treatment of uveitis and dry eye syndrome in autoimmune diseases. Their further development can contribute to establishment of the principles of medical care, in order to improve efficiency of treatment and quality of life in the patients. Further research and accumulation of data in the field are needed.
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