自身免疫性巩膜炎:发病机制与治疗新视角

Rudkovska Oksana
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摘要

目前,自身免疫性巩膜炎的发病机制尚不完全清楚,诱发因素不明,治疗效果不佳。笔者假设:巩膜炎的诱因可能是遗传(眼球前段 "过紧")和表观遗传(长期压力)因素导致的调节功能减弱。为了恢复调节能力,建议:a).在眼球上半部进行圆形非穿透性巩膜上切除术(模仿前巩膜葡萄肿);b).在角膜上形成简单的近视散光,最高可达 1.c). 如有必要,进行激光散瞳。手术参数应通过实验确定。这种手术方法可用于治疗全身性自身免疫性疾病,这些疾病通常与巩膜炎有关,并可能有一个共同的诱因--适应不良。
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Autoimmune scleritis: A new look at etiopathogenesis and treatment
At present, the etiopathogenesis of autoimmune scleritis is not fully understood, the trigger of the disease is unknown, and treatment is ineffective. The author's hypothesis: the trigger of scleritis may be a weakness of accommodation caused by genetic ("tight" anterior segment of the eye) and epigenetic (chronic stress) factors. In order to restore accommodation, it is proposed to: a). form rounded non-penetrating supraciliary sclerectomies in the upper half of the eyeball (imitation of anterior scleral staphyloma); b).to form simple myopic astigmatism in the cornea up to 1.5 diopters, which gives the maximum amount of pseudo-accommodation (imitation of the effect of peripheral ulcerative keratitis on the refraction of the eye). c). if necessary, to form laser mydriasis. The parameters of operations should be established experimentally. This surgical approach can be applied to the treatment of systemic autoimmune diseases, which are often associated with scleritis and may have a common trigger - poor accommodation.
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