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继发性青光眼是葡萄膜炎患者常见的致盲性并发症,发生率约为10%。常见类型有青光眼睫状体炎综合征、Fuchs综合征、幼年性关节炎相关的葡萄膜炎、病毒性葡萄膜炎、HLA-B27相关性葡萄膜炎、中间葡萄膜炎、Vogt-小柳原田病、Behcet病和类肉瘤病。发生机制与虹膜周边前粘连、瞳孔阻滞、小梁网炎症、Schlemm管功能异常、睫状体肿胀或长时间应用糖皮质激素滴眼液等有关。主要治疗措施是在积极抗炎的基础上应用降眼压药物治疗,眼压难以控制或发生视神经损害时应采用手术治疗,常见术式有虹膜切开术、术中加用抗代谢药物的滤过性手术、房水引流阀植入术或睫状体光凝术等,术前积极控制葡萄膜的炎症可提高手术成功率。就葡萄膜炎继发性青光眼的临床诊治进展进行综述。
Secondary glaucoma is a common blinding complications in patients with uveitis, the incidence was about 10%. Common types are glaucomatocytosis syndrome, Fuchs syndrome, juvenile arthritis-associated uveitis, viral uveitis, HLA-B27-associated uveitis, intermediate uveitis, Vogt-Kobayashi Harada disease Behcet’s disease and sarcoidosis. Occurrence mechanism and the iris before the adhesion, pupillary block, trabecular meshwork inflammation, Schlemm’s tube dysfunction, ciliary body swelling or prolonged use of glucocorticoid eye drops and so on. The main treatment is the application of antihypertensive drugs on the basis of active anti-inflammatory treatment, intraocular pressure is difficult to control or optic nerve damage should be treated with surgery, a common surgical iridectomy, intraoperative use of anti-metabolic drugs filter Preoperative surgery, aqueous humor valve implantation or ciliary body photocoagulation, preoperative control of uveal inflammation can improve the success rate of surgery. The progress of clinical diagnosis and treatment of secondary glaucoma of uveitis is reviewed.