[葡萄膜炎和多发性硬化症:临床方面、诊断、管理和治疗]。

Die Ophthalmologie Pub Date : 2024-08-01 Epub Date: 2024-07-22 DOI:10.1007/s00347-024-02084-8
Nicole Stübiger, Klemens Ruprecht, Uwe Pleyer
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引用次数: 0

摘要

约有 0.5-1% 的多发性硬化症(MS)患者同时患有葡萄膜炎。眼内炎症和多发性硬化症主要影响年轻女性。多发性硬化症患者多伴有双侧中间葡萄膜炎,同时伴有典型的视网膜血管炎。这两种疾病都具有类似的特点,即慢性炎症性疾病具有复发性病程和免疫介导的发病机制;然而,目前还不清楚葡萄膜炎和多发性硬化症同时出现在同一患者身上是两种不同疾病实体的巧合,还是葡萄膜炎是多发性硬化症的一种罕见临床表现。在中间葡萄膜炎的鉴别诊断中,应考虑多发性硬化症的临床症状和体征。由于这两种疾病都被认为是免疫介导的,因此免疫疗法是主要的治疗方法。近年来,药物种类不断增加,其中包括几种改变疾病的药物(生物制剂)。在选择活性物质时,必须考虑到多发性硬化症患者禁用肿瘤坏死因子(TNF)α受体阻滞剂。
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[Uveitis and multiple sclerosis : Clinical aspects, diagnostics, management and treatment].

Approximately 0.5-1% of patients with multiple sclerosis (MS) have co-existing uveitis. Both intraocular inflammation and MS mainly affect women in younger adulthood. The MS in patients is most frequently associated with an often bilateral intermediate uveitis with typical concomitant retinal vasculitis. Both diseases share similar characteristics with chronic inflammatory diseases with a relapsing course and an immune-mediated pathogenesis; however, it is still unclear whether the co-occurrence of uveitis and MS in the same patient represents a coincidence of two separate disease entities or whether uveitis is a rare clinical manifestation of MS. In the differential diagnostics of intermediate uveitis, clinical symptoms and signs of MS should be considered. As both diseases are considered to be immune-mediated, immunotherapy is the main treatment option. In recent years the range of medications has expanded and includes several disease modifying drugs (biologics). When selecting the active substance it must be taken into account that tumor necrosis factor (TNF) alpha blockers are contraindicated in patients with MS.

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