评估葡萄膜炎的炎症反应程度:临床方法的诊断能力

I. Gndoyan, A. V. Petraevsky, Viktoriya V. Chubarikova
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摘要

葡萄膜炎症性疾病在工作年龄段的人群中发病率和流行率都很高。葡萄膜炎并发症常常导致不同年龄段的患者失明或视力低下。诊断和监测葡萄膜炎的疗效需要使用定量标准来评估炎症反应的程度。本综述旨在分析葡萄膜炎患者眼球前后节段炎症反应主观和客观评估的各种临床方法的信息价值和准确性。在日常临床实践中,要评估葡萄膜炎的炎症反应,最常使用的是生物显微镜,其特点是与眼科医生的资质水平有关的主观性。其他临床方法,如荧光素血管造影术、光学相干断层扫描-血管造影术等,具有较高的灵敏度和信息价值,而且不受检查者主观印象的影响。然而,前者具有侵入性,而后者目前仍无法为广大眼科医生所用,尤其是在 "血管 "模式下。激光耀斑光度法对葡萄膜炎的诊断具有特别重要的意义。它既是一种非侵入性方法,又是一种灵敏的方法,可以获得描述葡萄膜炎症活动的定量指标。这种方法的应用和发展前景对临床实践和研究都很重要。
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Assessment of the degree of inflammatory reaction in uveitis: diagnostic capabilities of clinical methods
Inflammatory diseases of the uvea demonstrate a high incidence and a significant prevalence among people of working age. Uveitis complications often lead to blindness and low vision in patients of various age groups. Diagnostics and monitoring the efficacy of uveitis therapy requires the use of quantitative criteria to assess the degree of inflammatory reaction. The aim of this review is to analyze the informative value and accuracy of various clinical methods for subjective and objective assessment of the inflammatory reaction in the anterior and posterior segments of the eye in uveitis. To assess the inflammatory reaction in uveitis in everyday clinical practice, biomicroscopy is most often used, which is characterized by subjectivity associated with the level of qualification of the ophthalmologist. Other clinical methods, such as fluorescein angiography, optical coherence tomography-angiography, have high sensitivity and informative value along with independence from the subjective impression of the examiner. However, the first of them is invasive, and the second is still not available to a wide range of practicing ophthalmologists today, especially in the “angio” mode. Laser flare photometry is of special importance in the diagnosis of uveitis. It is both a non-invasive and sensitive method that makes it possible to obtain quantitative indicators characterizing the activity of uveal inflammation. The prospects for the application and development of this method are important both for clinical practice and for research purposes.
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