第十二章葡萄膜炎第一节前葡萄膜炎(虹膜炎虹膜睫状体炎)郝晓军(整理)打杂组出品20141110.docx

尖峰眼科wills手册 第十二章 葡萄膜炎 第一节 前葡萄膜炎(虹膜炎/虹膜睫状体炎) 郝晓军（整理）打杂组出品 2014.11.10Chapter 12 Uveitis?第十二章 葡萄膜炎12.1 Anterior Uveitis (Iritis/Iridocyclitis)第一节 前葡萄膜炎(虹膜炎/虹膜睫状体炎)Symptoms?【症状】1、Acute: Pain, redness, photophobia, consensual photophobia (pain in the affected eye when a light is shone in the fellow eye), excessive tearing, decreased vision.1.急性期?眼痛;眼红;畏光或交感性畏光，即光照对侧眼时，患眼发生疼痛;大量溢泪;视力下降。2、Chronic: Decreased vision (from vitreous debris, cystoid macular edema (CME), or cataract). May have periods of exacerbations and remissions with few acute symptoms [e.g. juvenile idiopathic (rheumatoid) arthritis (JIA/JRA)].2.慢性期?视力下降，由玻璃体碎屑、黄斑囊样水肿、或白内障造成。可有急性期症状的加重时期和缓解时期，如青少年性特发性(类风湿性)关节炎(JIA/JRA)。Signs?【体征】Critical. Cells and flare in the anterior chamber, ciliary flush, keratic precipitates (KP)主要体征：房水细胞和房水闪辉，睫状充血，角膜后沉着物(KP)。?-?Fine (“stellate”; typically covers entire corneal endothelium): herpetic, Fuchs heterochromic iridocyclitis (FHIC), cytomegalovirus (CMV) retinitis, others.1.细小KP??星状的，弥漫性分布于全角膜内皮层。见于疱疹病毒感染、Fuchs虹膜异色性虹膜睫状体炎(FHIC)、巨细胞病毒性(CMV)视网膜炎等。?-?Small, nongranulomatous: HLA-B27 associated, trauma, masquerade, JIA, Glaucomatocyclitic crisis, and all of the granulomatous entities.2.小的非肉芽肿性KP??见于人类白细胞抗原(HLA)-B27相关性葡萄膜炎、眼外伤、青少年性特发性(类风湿性)关节炎JIA、伪装综合征、青光眼睫状体炎综合征和所有的肉芽肿性疾病。?-?Granulomatous KP: large, greasy (“mutton-fat”; mostly on inferior cornea): sarcoidosis, syphilis, tuberculosis, lens-induced, Vogt–Koyanagi–Harada (VKH) syndrome, others.3.肉芽肿性KP??大的、羊脂状KP，最常见于下方角膜。见于结节病、梅毒、结核、人工晶体诱发的葡萄膜炎、Vogt-小柳-原田(Vogt-Koyanagi-Harada,VHK)综合征等。Other.?【其他体征】Low intraocular pressure (IOP) more commonly seen (secondary to secretory hypotony of the ciliary body),1.低眼压?更多见。继发于睫状体的分泌减少。elevated IOP can occur (e.g., herpetic, lens-induced, FHIC, Posner–Schlossman syndrome),2.眼压升高?常见于疱疹病毒感染、人工晶体诱发的葡萄膜炎、Fuchs虹膜异色性虹膜睫状体炎和Posner-Schlossman综合征。fibrin (HLA-B27 or endophthalmitis),3.前房内纤维素性渗出?见于HLA-B27相关性葡萄膜炎或眼内炎。hypopyon (HLA-B27, Beh?et disease, infectious endophthalmitis, rifabutin, tumor),4.前房积脓?见于H