{"title":"自身免疫性巩膜炎:发病机制与治疗新视角","authors":"Rudkovska Oksana","doi":"10.15406/aovs.2024.12.00463","DOIUrl":null,"url":null,"abstract":"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.","PeriodicalId":287670,"journal":{"name":"Advances in Ophthalmology & Visual System","volume":"9 2","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Autoimmune scleritis: A new look at etiopathogenesis and treatment\",\"authors\":\"Rudkovska Oksana\",\"doi\":\"10.15406/aovs.2024.12.00463\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"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.\",\"PeriodicalId\":287670,\"journal\":{\"name\":\"Advances in Ophthalmology & Visual System\",\"volume\":\"9 2\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-06-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Advances in Ophthalmology & Visual System\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.15406/aovs.2024.12.00463\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in Ophthalmology & Visual System","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.15406/aovs.2024.12.00463","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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.