中间葡萄膜炎的临床特征与治疗

Clinical features and treatment of intermediate uveitis

目的 观察中间葡萄膜炎的临床表现、并发症和治疗效果。方法回顾分析36例中间葡萄膜炎患者66只眼的临床表现、荧光素眼底血管造影（FFA）特征、治疗效果和预后。患者中男21例，女15例，年龄8～70岁，平均年龄34．8岁。双眼30例，单眼6例。结果主要临床表现为玻璃体混浊，周边部视网膜血管病变，视盘水肿，黄斑水肿和后囊下白内障。FFA表现为周边部视网膜血管炎性病变，视盘强荧光，黄斑囊样水肿和视网膜静脉染色。经治疗后，31例患者60只眼视力提高，占90．9％；4例5只眼视力稳定，占7．6％；1例1只眼视力下降，占1．5％。导致视力损害的主要并发症有黄斑囊样水肿、后囊下白内障和玻璃体积血。结论中间葡萄膜炎是一种较常见的双眼慢性进行性眼内炎症，主要累及前部玻璃体、睫状体扁平部和周边部视网膜血管，早期发现和及时治疗可防止发生永久性视力损害。

Objective To observe the clinical features, the complications and treatment effects of intermediate uveitis. Methods The clinical data of 36 patients （66 eyes） with intermediate uveitis were retrospectively analyzed,including the clinical features, fundus fluorescein angiography （FFA） features, complications,treatment effects and prognosis. The patients, 21 males and 15 females, aged from 8 to 70 years, with the mean age of 34. 8 years. There were 30 cases with bilateral lesions and 6 cases with unilateral lesions. Results The main clinical manifestation were vitreous opacity, peripheral retinal venous lesions, optic disc edema, macular edema and posterior subcapsular cataract. The results of FFA showed that peripheral retinal venous lesions, optic disc hyperfluorescence, cystoid macular edema and retinal vein staining. After the treatment, the visual acuity of 31 cases （60 eyes, 90.9% ） were improved, 4 cases（5 eyes,7.6%） were stable and 1 case（1 eye,1.5%） was worsening. The main complications were eystoid macular edema, posterior subcapsular cataract and vitreous hemorrhage which leads to visual damage. Conclusions Intermediate uveitis was a common bilateral and chronic progressive intraoeular inflammation, the anterior vitritis, pars plana and peripheral retinal vascular changes were mainly involved. Early diagnosis and proper treatment may prevent the permanent visual damage.