Retinal vasculitis.
Retinal vasculitis.
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DOI：
10.1097/bor.0000000000000271
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发表时间：
2016-05
影响因子：
5.1
通讯作者：
Lin P
中科院分区：
文献类型：
--
作者：
Rosenbaum JT;Sibley CH;Lin P
眼科医生和风湿科医生在咨询视网膜血管炎患者时经常发生沟通错误。这份报告试图建立对视网膜血管炎这一术语的共同理解，并回顾最近关于这一诊断的论文。1)最近描述了一些罕见形式的视网膜血管疾病的遗传学基础。已确定的基因包括CAPN5、TREX1和TNFAIP3；2)Behçet病是一种非常常见的与阻塞性视网膜血管炎相关的全身性疾病；3)包括荧光素血管造影在内的视网膜成像和其他较新的成像手段已被证明对识别和表征视网膜血管炎及其并发症至关重要；4)尽管抗IL-17A或IL-1β的单抗在治疗Behçet病的试验中失败，但抗肿瘤坏死因子α的抗体，无论是英夫利昔单抗还是阿达单抗，都显示出在治疗这种疾病方面的一致益处。通过利妥昔单抗进行干扰素治疗和B细胞去除治疗对某些类型的视网膜血管炎可能是有益的。视网膜血管炎是风湿科医生需要了解的一个重要实体。与Behçet病相关的视网膜血管炎对中和肿瘤坏死因子的单抗有反应，但许多其他形式的非感染性视网膜血管炎可能需要替代治疗。
Ophthalmologists and rheumatologists frequently miscommunicate in consulting on patients with retinal vasculitis. This report seeks to establish a common understanding of the term, retinal vasculitis, and to review recent papers on this diagnosis. 1) The genetic basis of some rare forms of retinal vascular disease have recently been described. Identified genes include CAPN5, TREX1, and TNFAIP3; 2) Behçet’s disease is a systemic illness that is very commonly associated with occlusive retinal vasculitis; 3) retinal imaging including fluorescein angiography and other newer imaging modalities has proven crucial to the identification and characterization of retinal vasculitis and its complications; 4) although monoclonal antibodies to IL-17A or IL-1 beta failed in trials for Behçet’s disease, antibodies to TNF alpha, either infliximab or adalimumab, have demonstrated consistent benefit in managing this disease. Interferon treatment and B cell depletion therapy via rituximab may be beneficial in certain types of retinal vasculitis. Retinal vasculitis is an important entity for rheumatologists to understand. Retinal vasculitis associated with Behçet’s disease responds to monoclonal antibodies that neutralize TNF, but the many other forms of non-infectious retinal vasculitis may require alternate therapeutic management.