Karoline Baquet-Walscheid, Thomas Rath, A. Heiligenhaus
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引用次数: 0
摘要
风湿病的眼部表现很常见,严重影响患者的发病率和生活质量。了解典型的临床表现对风湿免疫科医生来说非常重要,有助于在疾病的早期阶段为有相应症状的患者提供眼科咨询,或启动定期筛查(如白塞氏综合征患者)。反之,对某些眼科疾病进行(可能是紧急的)风湿病学评估至关重要,以免忽视(可能是致命的)全身性相关疾病。风湿性或炎症性眼病患者的主治医生应始终向其告知其他器官可能出现的症状,以避免延误诊断。葡萄膜炎的 "经典 "关联是(HLA-B27相关)脊柱关节炎和急性前葡萄膜炎,以及伴有或不伴有泛葡萄膜炎的视网膜血管炎和贝赫切特综合征。然而,类风湿性关节炎或 ANCA 相关性血管炎患者通常会出现巩膜炎(伴或不伴外周溃疡性角膜炎),但也有可能出现其他各种症状。密切的跨学科合作,尤其是在治疗决策方面的合作,对于确保患者的良好预后至关重要。
Ocular Involvement in Selected Rheumatic Diseases - Clinical Manifestation in Adulthood.
Ocular manifestations of rheumatic diseases are common and contribute significantly to the morbidity and reduced quality of life of affected patients. Knowledge of typical clinical manifestations is important for the rheumatologist in order to support the reference of patients with corresponding symptoms for ophthalmological consultation at an early stage of disease, or to initiate regular screening examinations (e.g. in patients with Behçet's syndrome). Conversely, a (possibly urgent) rheumatological assessment is crucial for certain ophthalmological diseases, in order not to overlook a (possibly fatal) systemic associated disease. Patients with rheumatic or inflammatory ocular diseases should always be informed by the treating physician about possible symptoms of other organ manifestations, in order to avoid a delayed diagnosis. "Classic" associations for uveitis are (HLA-B27-associated) spondyloarthritis and acute anterior uveitis, as well as retinal vasculitis with or without panuveitis and Behçet's syndrome. In patients with rheumatoid arthritis or ANCA-associated vasculitis, however, scleritis (with or without peripheral ulcerative keratitis) typically occurs, but a variety of other findings are also possible. Close interdisciplinary collaboration, particularly regarding therapeutic decisions, is crucial to ensuring a good prognosis for the patient.