Neuro-ophthalmologic manifestations in systemic lupus erythematosus
Neuro-ophthalmologic manifestations in systemic lupus erythematosus
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DOI：
10.1177/0961203316683265
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发表时间：
2017-04-01
期刊：
影响因子：
2.6
通讯作者：
Abramino Levy, R.
中科院分区：
文献类型：
--
作者：
de Andrade, F. A.;Guimaraes Moreira Balbi, G.;Abramino Levy, R.
系统性红斑狼疮（SLE）是一种慢性自身免疫性疾病，可影响不同的眼部结构，如角膜、结膜、巩膜外层、巩膜、葡萄膜、视网膜、视神经和血管。 SLE 的神经眼科表现包括不同程度的视网膜、脉络膜和视神经受累。视网膜变化是最常见的眼部病变之一，即使是孤立的，也经常被用作活动的临床标准。研究表明，高达 29% 的活动性 SLE 患者出现视网膜疾病。脉络膜疾病的确切患病率尚不清楚，但由于诊断不足，被认为不如视网膜病变常见。视神经疾病，以视神经炎和前/后缺血性视神经病变为代表，影响约 1% 的 SLE 患者。这些眼部表现与神经系统症状、抗磷脂抗体、肾病和死亡率增加有关。本文的目的是回顾 SLE 神经眼科参与的不同方面。由于这些表现很常见并且可能很严重，因此需要多专业团队的方法来正确调查并提供早期积极治疗，以避免视觉后遗症。
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect different ocular structures, such as cornea, conjunctiva, episclera, sclera, uveal tract, retina, optic nerve and vessels. Neuro-ophthalmologic manifestations in SLE include different degrees of involvement of retina, choroid and optic nerve. Retinal changes are one of the most common ocular involvements and are frequently used as clinical criteria for activity, even if isolated. Studies show that up to 29% of patients with active SLE manifest retinal disease. The exact prevalence of choroidal disease is unknown, but is thought to be less common than retinopathy, due to under-diagnosis. Optic nerve disease, represented by optic neuritis and anterior/posterior ischaemic optic neuropathy, affects approximately 1% of SLE patients. These ocular manifestations have been associated with neurologic flares, antiphospholipid antibodies, nephropathy, and increased mortality. The aim of this paper is to review the different aspects of neuro-ophthalmologic involvement in SLE. Since these manifestations are frequent and potentially severe, a multi-professional team approach is needed to investigate properly and provide early aggressive treatment in order to avoid visual sequelae.