葡萄膜炎诊断中正确应用眼内液检测

Application of intraocular fluid testing in the diagnosis of uveitis

眼内液检测是指采用房水或玻璃体样本进行的实验室检查,可用于某些类型葡萄膜炎的诊断.本文概述了眼内液检测的具体内容和检查结果的解读,阐述了其在葡萄膜炎诊断中的适应证,并对目前此类检查中存在的误区及其带来的后果进行了剖析.绝大多数葡萄膜炎患者可根据病史、临床检查及辅助检查即可做出诊断,并不需要进行眼内液检测,仅在少数特定的炎症如眼内炎、肿瘤所致的伪装综合征、眼弓形虫病、眼弓蛔虫病等才需进行眼内液检测.过度依赖眼内液检测查找病因不仅增加了感染的风险,对多数葡萄膜炎的病因诊断帮助不大甚至误诊误治.

Intraocular fluid testing is a laboratory examination used in the diagnosis of certain intraocular inflammatory diseases or in the investigation of relevant factors associated uveitis.The specific examinations and their indications of intraocular fluid testing as well as explanation of the test results obtained are described in detail in this paper.The abused employment of intraocular fluid testing and misunderstanding of these results become a serious problem right now in clinical practice.In general,the diagnosis of uveitis is a clinical one and principally based on history taking,meticulous clinical examination and,if necessary,relevant auxiliary exami nations.Intraocular fluid testing is useful only in the diagnosis of endophthalmitis,masquerade syndrome associated with malignancies,ocular toxoplasmosis and ocular toxocariasis.Extensive and indiscriminate intraocular fluid testing used in searching for underlying origins or causes of uveitis is a wasteful practice,frequently leading to misdiagnosis and mistreatment,and sometime puts patients at risk to development of intraocular infection.