系统性红斑狼疮并发眼底视网膜病变的临床研究

Clinical studies of systemtic lupus erythematosus with retinopathy

目的 探讨系统性红斑狼疮 (SLE)并发眼底视网膜病变的临床特征。方法 对 13例 2 6只眼SLE并发眼底视网膜病变的患者进行视力、眼底检查及检测抗核抗体 (ANA)、抗双链DNA(抗ds -DNA)、抗心磷脂抗体(ACA)、免疫球蛋白及补体等 ,8例行彩色眼底照相及眼底荧光血管造影 (FFA)。结果 所有患者发病时均处于活动期。有 8例视网膜血管阻塞的病人 ,其中 6例出现中枢神经系统病变。本组病例中视网膜棉絮状渗出检出率最高 (5 7.7% ) ,其次为视网膜血管阻塞 (4 6 .2 % )。视力在 0 .1以下 13只眼 ,其中 7只由视网膜血管阻塞所致 ,4只由视网膜棉絮状渗出所致。结论 SLE视网膜病变多出现在狼疮的活动期 ;眼底视网膜病变中以棉絮样斑及视网膜血管阻塞最常见 ;视网膜血管阻塞病变的狼疮患者 ,可能合并有中枢神经系统损害 ,同时对视力威胁最大。

Objective To investigate the clinical features of retinopathy secondary to systemic lupus erythematosus(SLE).Methods Visual acuities,fundus examination,antinuclear antibody (ANA) , anti-double-stranded DNA (anti-dsDNA) , anticardiolipin antibody(ACL), immunoglobulin, complement were detected in 13 SLE patients (26 eyes) with retinopathy. The colorful photos of fundus oculi and fundus fluoresenin angiography (FFA) were performed on 8 patients.Results All patients were at active phase. There were 8 patients with retinal vessel occlusion, 6 of which were complicated with lesion in central nerve system.The incidence of the the batt-like exudation in retina were the highest(57.7%), followed by retinal vessel occlusion(46.2%). There were 13 eyes whose eyesight were less than 0.1,7 of which were caused by retinal vessel occlusion, 4 of which were caused by the batt-like exudation in retina.Conclusion SLE with retinopathy appears in active phase . The batt-like exudation and retinal vessel occlusion is most common lesion among these patients. Blockage of retinal vessel in patients with SLE may be associated with lesion in central nerve system.and greatly threaten to the eyesight.