病毒性葡萄膜炎的实验室诊断方法研究现状

Laboratory diagnosis of viral uveitis: current status

病毒性葡萄膜炎是临床常见的葡萄膜炎之一,是重要的致盲性眼病。其病因复杂,发病机制尚不明确,临床表现多样化,易与其他类型的葡萄膜炎混淆,较难及时进行病因诊断。由于病毒性葡萄膜炎较难针对病因进行治疗,常常存在不规范治疗,导致病情的迁延和反复。因此及时、准确的诊断该疾病对患者的治疗和预后有着重要意义。当前实验室检查中,针对病毒性葡萄膜炎的检查方法主要有病毒分离和培养(确诊检查)、病毒抗原或抗体测定、眼部标本的组织病理学检查及病毒DNA检测等。笔者就目前临床及科研中病毒性葡萄膜炎的实验室诊断方法进行综述。

Viral uveitis is a major blindness-causing eye disease ,which is commonly encountered in clinics. Although it has been reported that herpes simplex virus, varicella zoster virus, cytomegalovirus, and EB virus may cause viral uveitis, the exact mechanisms of the disease pathogenesis remain unclear. Since viral uveitis has highly diverse clinical manifestations and unclear distinctions from other types of uveitis, its timely and accurate diagnosis is difficult. Laboratory examination including virus isolation and culture has been considered as the gold standard of viral uveitis diagnosis. Recently, significant advances have been in the detection of viral antigens or antibodies in the peripheral blood and PCR-based viral DNA in biopsy specimens. Moreover,loop mediated isothermal amplification （LAMP） of viral DNA and Goldmann-Witmer coefficient analysis have been applied in the diagnosis of viral uveitis. This paper aims to review the cmxent literature on laboratory diagnosis of viral uveitis with a particular emphasis on the use of the latest technologies.