人类白细胞抗原-B27相关性急性前葡萄膜炎病情与脉络膜厚度变化的关系

Relationship between HLA-B27-related acute anterior uveitis and choroid thickness

目的探讨人类白细胞抗原(human leukocyte antigen,HLA)-B27相关性急性前葡萄膜炎(acute anterior uveitis,AAU)病情与脉络膜厚度变化的相关性。方法HLA-B27相关性AAU患者32例32眼及其对侧眼被纳入本研究,除对患者进行眼底荧光血管造影(fluorescein fundus angiography,FFA)等常规检查外,利用光学相干断层扫描(optical coherence tomography,OCT)对患者双眼黄斑中心凹下脉络膜厚度(subfoveal choroidal thickness,SFCT)及黄斑中心凹视网膜厚度(central foveal thickness,CFT)进行测量。对比AAU患者治疗前后SFCT及CFT变化。结果FFA显示,32眼HLA-B27相关性AAU患者视盘毛细血管均有荧光素渗漏(100.0%),其中13眼(40.63%)视网膜毛细血管荧光素渗漏。OCT检测结果显示,在炎症急性期,32眼HLA-B27相关性AAU患者的黄斑区脉络膜血管扩张显著。HLA-B27相关性AAU患眼的SFCT[(342.54±70.71)μm]较对侧眼的SFCT[(283.41±79.15)μm]显著增加(P=0.003),AAU患眼的CFT[(281.46±56.42)μm]与对侧眼的CFT[(268.49±51.91)μm]比较,差异无统计学意义(P=0.342)。经治疗炎症消退后,AAU患眼的SFCT减少至(284.13±99.07)μm,与治疗前相比,差异有统计学意义(P=0.009)。结论HLA-B27相关性AAU患眼SFCT增加,脉络膜厚度可作为评估HLA-B27相关性AAU病情严重程度的指标之一。

Objective To investigate the relationship between human leukocyte antigen(HLA)-B27-related acute anterior uveitis(AAU)with choroid thickness.Methods A total of 32 affected eyes and 32 fellow eyes of 32 patients with positive HLA-B27-related AAU were included in this study.In addition to routine examinations such as fluorescein fundus angiography(FFA),the subfoveal choroidal thickness(SFCT)and central foveal thickness(CFT)were measured for affected eyes and unaffected fellow eyes in AAU patients using optical coherence tomography(OCT).The changes of SFCT and CFT were compared before and after treatment.Results FFA showed optic disc capillary leakage in 32 HLA-B27-related AAU eyes,of which 13 eyes(40.63%)had retinal capillary leakage.OCT showed a significant choroidal vasodilation in macular area of 32 HLA-B27-associated AAU eyes in acute phase of inflammation.The SFCT was(342.54±70.71)μm for HLA-B27-related AAU-affected eyes,which was significantly higher than(283.41±79.15)μm for unaffected fellow eyes(P=0.003).The CFT was(281.46±56.42)μm for HLA-B27-related AAU-affected eyes,which had no significant difference with(268.49±51.91)μm for unaffected fellow eyes(P=0.342).After inflammation resolution,SFCT decreased significantly from(342.54±70.71)μm to(284.13±99.07)μm,and statistical difference was found(P=0.009).Conclusion SFCT increases significantly in eyes with HLA-B27-related AAU.Choroid thickness can be used as one of the indexes to evaluate the severity of HLA-b27-related AAU.