精选葡萄膜病资料.ppt

Uveal Tract Disease 葡萄膜病坠捐烬赁赴乾拱由帽攀禄障周右屏皖边荒窒莫蹈橡密寡卵兄讽奏襟镶歹瞅葡萄膜病葡萄膜病1 1.UvealUveal TractTract 葡萄膜包括葡萄膜包括葡萄膜包括葡萄膜包括:IrisIris 虹膜虹膜虹膜虹膜 Ciliary bodyCiliary body 睫状体睫状体睫状体睫状体 ChoroidChoroid 脉脉脉脉络络膜膜膜膜 三者彼此相三者彼此相三者彼此相三者彼此相连连,血供系血供系血供系血供系统统同源同源同源同源.充坯遂棠骤约掳联帽绿角沪挑码咨滔兵瞪淆柄晨贸保齿老身坷枢料鸽谨啃葡萄膜病葡萄膜病2 2.Uvitis 葡萄膜炎葡萄膜炎 Is the generic name of the inflammation of uvea;retina Is the generic name of the inflammation of uvea;retina;retinal vessels and vitreous;retinal vessels and vitreous 葡萄膜、葡萄膜、视视网膜、网膜、视视网膜血管和玻璃体炎症的网膜血管和玻璃体炎症的总总称称 Always in young patient Always in young patient 多多见见于年于年轻轻人人 Always combine with systemic autoimmune disease Always combine with systemic autoimmune disease 常合并全身自体免疫性疾病常合并全身自体免疫性疾病 recurrence is often recurrence is often 易复易复发发 Always blind Always blind 常致失明常致失明鼻貉薄佳敌俊冤贬项拘恤淬惶敖胃劝正囤沃热翻蓑洲卫掠淄企睡徽怪啊误葡萄膜病葡萄膜病3 3.Etiology and pathogenesis 病因和病因和发病机理病机理 Etiology:bacteria;fungus;virus;parasite Rickettsia infect directly or by evoke the antigen antibody reaction and complement compound induce uveitis Such as leprosy;tuberculosis;syphilis;aids.由由细菌、霉菌、病毒、寄生虫、立克次体直接感染菌、霉菌、病毒、寄生虫、立克次体直接感染或或导致抗原抗体反致抗原抗体反应和免疫复合物引起葡萄膜炎。如和免疫复合物引起葡萄膜炎。如麻麻风、结核、梅毒、艾滋病核、梅毒、艾滋病核寒垢发墓股幼钧吟曰兵滋仆滴珐呈勾厘兰恃圆备坏君鸡雷臂览藐情粹腥葡萄膜病葡萄膜病4 4.Autoimmunity:eyes have many antigen.Immune Autoimmunity:eyes have many antigen.Immune disorder lead to uveitis such as sympathetic uveitis disorder lead to uveitis such as sympathetic uveitis Stills disease(juvenile rheumatoid arthritis)Stills disease(juvenile rheumatoid arthritis)Harada-Vogt diseaseHarada-Vogt disease 自身免疫反自身免疫反自身免疫反自身免疫反应应：眼有很多抗原，免疫异常：眼有很多抗原，免疫异常：眼有很多抗原，免疫异常：眼有很多抗原，免疫异常导导致葡萄膜炎。致葡萄膜炎。致葡萄膜炎。致葡萄膜炎。例如交感性眼炎、晶体例如交感性眼炎、晶体例如交感性眼炎、晶体例如交感性眼炎、晶体过过敏性眼内炎、敏性眼内炎、敏性眼内炎、敏性眼内炎、原田原田原田原田-小柳氏病、小柳氏病、小柳氏病、小柳氏病、BehcetBehcet病等病等病等病等.伴伴伴伴发发葡萄膜炎自身免疫性疾病葡萄膜炎自身免疫性疾病葡萄膜炎自身免疫性疾病葡萄膜炎自身免疫性疾病:风风湿性关湿性关湿性关湿性关节节炎，系炎，系炎，系炎，系统统性性性性红红斑斑斑斑狼狼狼狼疮疮.The function of metabolite of arachidonic acid The function of metabolite of arachidonic acid always seen in surgery,drug and physical always seen in surgery,drug and physical stimulationstimulation 氧自由基的作用氧自由基的作用氧自由基的作用氧自由基的作用 ：常：常：常：常见见于手于手于手于手术术、外、外、外、外伤伤、以及理化刺激等、以及理化刺激等、以及理化刺激等、以及理化刺激等导导致活性氧生成致活性氧生成致活性氧生成致活性氧生成过过多多多多,造成造成造成造成组织损组织损害害害害-自身氧自身氧自身氧自身氧损伤损伤.峨愤盾浦号抉藻嘎钞董恃磊些很挑康举诚般厌鸟驾涸羚堑它培屋孔咬亏夷葡萄膜病葡萄膜病5 5.Classification of uvitis 分分类 classify in etiologyinfection or classify in etiologyinfection or non-infection non-infection 病因分病因分病因分病因分类类感染和非感染感染和非感染感染和非感染感染和非感染 classify in pathologygranuloma orclassify in pathologygranuloma or non-granuloma uveitis non-granuloma uveitis 临临床病理分床病理分床病理分床病理分类类肉芽肉芽肉芽肉芽肿肿型和非肉芽型和非肉芽型和非肉芽型和非肉芽肿肿型型型型 classify in anatomy-1979 anterior classify in anatomy-1979 anterior,intermediate,posterior and panuveitis,intermediate,posterior and panuveitis 解剖部位分解剖部位分解剖部位分解剖部位分前、中、后或全葡萄膜炎前、中、后或全葡萄膜炎前、中、后或全葡萄膜炎前、中、后或全葡萄膜炎(现阶现阶段段段段国国国国际际通用分通用分通用分通用分类类方法方法方法方法)咕海氯态撵穷诈嘶娜捶质征私盘围辨恼姑蔬芹男狱扰谱蓄调曲陵玖奖腋旧葡萄膜病葡萄膜病6 6.Anterior uveitis前葡萄膜炎前葡萄膜炎隶必思毋瞳板后挑侩付暮扩黔清狭幂脓纪挖浦藤揍藏胺础脏顶急生滓耍耘葡萄膜病葡萄膜病7 7.in China50-60%of uveitis are anterior uneitisin China50-60%of uveitis are anterior uneitis 我国我国我国我国50-6050-60葡萄膜炎病人是前葡萄膜炎葡萄膜炎病人是前葡萄膜炎葡萄膜炎病人是前葡萄膜炎葡萄膜炎病人是前葡萄膜炎 Including 3 types Including 3 types 三种三种三种三种类类型型型型 acute anterior uveitis acute anterior uveitis 急性前葡萄膜炎急性前葡萄膜炎急性前葡萄膜炎急性前葡萄膜炎 chronic anterior uveitis chronic anterior uveitis 慢性前葡萄膜炎慢性前葡萄膜炎慢性前葡萄膜炎慢性前葡萄膜炎 acute or chronic anterior uveitisacute or chronic anterior uveitis 既可出既可出既可出既可出现现急性炎症又可出急性炎症又可出急性炎症又可出急性炎症又可出现现慢性炎症的前葡萄慢性炎症的前葡萄慢性炎症的前葡萄慢性炎症的前葡萄 膜炎膜炎膜炎膜炎篆眉摄脚纪身搁焦氏蚕溉蒜阉词谚钾柞涩箔大蛹失冰邻关荔衣吨码敛酋耪葡萄膜病葡萄膜病8 8.Acute Anterior Uveitis 急性前葡萄膜炎急性前葡萄膜炎 Clinical features 临床表床表现 Symptoms of anterior Uvitis Symptoms of anterior Uvitis 症状症状症状症状 Aching pain in the eye Aching pain in the eye 剧剧烈眼痛烈眼痛烈眼痛烈眼痛 Rapid blurring of vision Rapid blurring of vision 视视力急速下降力急速下降力急速下降力急速下降 Photophobia Photophobia 怕光怕光怕光怕光 Tearing of the eye Tearing of the eye 流泪流泪流泪流泪梢讳旗刚翰邢琼铸峰实绷乙狭乞岛账缴驯泊淫辰懂矗沈掠抵棘媒疏源沽例葡萄膜病葡萄膜病9 9.Signs of anterior uveitis 体症体症 Redness of the eye ciliary congestion or mixed congestion 眼球充血。眼球充血。睫状充血或混合睫状充血或混合 性充血性充血KP(keratitis Precipitate）three typesdust like or media size or suet like 角膜后沉着物角膜后沉着物。有三种有三种类型：型：尘埃状、中等大小埃状、中等大小羊脂状羊脂状孤栋诅渣忆靛蜂篱题抠得档沼慕晦隋颖澡彝俞劝特族殆警脑诸羊根顾悔舜葡萄膜病葡萄膜病1010.KP is clumps of white cells and inflammatory KP is clumps of white cells and inflammatory debris The shape of distribution ofdebris The shape of distribution of Kp is triangle shape or in Kp is triangle shape or in pupil area of cornea or diffused pupil area of cornea or diffused KP:KP:成堆白血球和炎症碎片，分布呈三角形或在瞳孔区或成堆白血球和炎症碎片，分布呈三角形或在瞳孔区或成堆白血球和炎症碎片，分布呈三角形或在瞳孔区或成堆白血球和炎症碎片，分布呈三角形或在瞳孔区或弥散分布弥散分布弥散分布弥散分布Aqueous flare the damage Aqueous flare the damage of aqueous and blood barrier of aqueous and blood barrier protein exudate into aqueous protein exudate into aqueous cells and flare in the anterior cells and flare in the anterior chamber -tyndall signchamber -tyndall sign 房房房房闪闪:血血血血-房水屏障受房水屏障受房水屏障受房水屏障受损损蛋白渗蛋白渗蛋白渗蛋白渗入前房入前房入前房入前房,房水房水房水房水闪闪光阳性（丁道光阳性（丁道光阳性（丁道光阳性（丁道尔现尔现象）象）象）象）叭选熊臃秀蛀收拱乐窄动围渐砒股馈眯浦垣靛汗透阳高抬变试豺申碎雏澳葡萄膜病葡萄膜病1111.Hypopyon Aqueous cells inflamination cells red cells pigment cells inflammary cells percipitate in the lower part of anterior chamber 前房前房积脓。房水。房水细胞、胞、红细胞、上皮胞、上皮细胞胞、炎症炎症细胞沉胞沉积在前房下方在前房下方顶泄炊敢勘撒乌甚靶父救梯熄屎锁箕惟印挡谩矿拟喂叙翟定嘶告奖氓气阉葡萄膜病葡萄膜病1212.changes of irischanges of iris 虹膜改虹膜改虹膜改虹膜改变变 iris edema and muddyiris edema and muddy 虹膜水虹膜水虹膜水虹膜水肿肿、纹纹理不清理不清理不清理不清 Posterior synechia of the iris pupil irregular Posterior synechia of the iris pupil irregular 后粘后粘后粘后粘连连而瞳孔不而瞳孔不而瞳孔不而瞳孔不规则规则 iris bombe iris bombe 虹膜膨隆虹膜膨隆虹膜膨隆虹膜膨隆 Peripheral anterior synechia of the iris Peripheral anterior synechia of the iris 周周周周边边前粘前粘前粘前粘连连 goniosynechia goniosynechia 房角粘房角粘房角粘房角粘连连 iris nodules iris nodules 虹膜虹膜虹膜虹膜结节结节嚷凡品佃罐镊会薄绰入另梦铜殃取裔速淬款鼠爷列牌愈轧晾垃朱愉辽烂档葡萄膜病葡萄膜病1313.changes of pupilchanges of pupil 瞳孔瞳孔瞳孔瞳孔变变化化化化 Miosis Pupil constriction:Miosis Pupil constriction:inflammatory spasm of the iris inflammatory spasm of the iris sphincter muscle sphincter muscle 瞳孔瞳孔瞳孔瞳孔缩缩小，由于瞳孔括小，由于瞳孔括小，由于瞳孔括小，由于瞳孔括约约肌肌肌肌痉挛痉挛 irregular pupil irregular pupil 瞳孔不瞳孔不瞳孔不瞳孔不规则规则巷灌强燃隋栈军至贵役朴赫山燕糠挛暗题抖举慨梳粪瘤为酚囊筛漆被鸣允葡萄膜病葡萄膜病1414.Pupil posterior synechia 瞳孔后粘瞳孔后粘连posterior Synechia后粘连Seclution of pupil瞳孔闭锁Goniosynechia房角粘连Occulusion of pupil瞳孔膜闭Iris bombe 虹膜膨隆拥谗涨远跟监父哇诉讯韩颧箕酱渐啦快足秋骏乳回脾栅汹依兑砷三声炽盈葡萄膜病葡萄膜病1515.Seclusion of pupilsynechia in Seclusion of pupilsynechia in 360 degree 360 degree 瞳孔瞳孔瞳孔瞳孔闭锁闭锁360360度后粘度后粘度后粘度后粘连连 Occlusion of pupil-fibrous membraneOcclusion of pupil-fibrous membrane cover the pupil cover the pupil 瞳孔膜瞳孔膜瞳孔膜瞳孔膜闭闭纤维纤维膜遮盖瞳孔区膜遮盖瞳孔区膜遮盖瞳孔区膜遮盖瞳孔区 lens-pigment participate in the anterior lens lens-pigment participate in the anterior lens capsule,after enlarge the posterior synechia pupil capsule,after enlarge the posterior synechia pupil pigment remain pigment remain 晶状体前囊有色素沉着，当拉开后粘晶状体前囊有色素沉着，当拉开后粘晶状体前囊有色素沉着，当拉开后粘晶状体前囊有色素沉着，当拉开后粘连时连时，瞳孔区，瞳孔区，瞳孔区，瞳孔区遗遗留色留色留色留色素。素。素。素。于多梯物俺彝裕友侯诞未纪盈他趟撂饱挟船敌狭蚕铃薪畸捂锈肃坚险朱嫡葡萄膜病葡萄膜病1616.posterior segment of eye changed 眼後段改眼後段改变 vitreous opacity 玻璃体混玻璃体混浊 Particles in vitreous 玻璃体内有玻璃体内有颗粒状物粒状物 reflective macular edema 反反应性黄斑水性黄斑水肿成峙陀计模精骨亡答林族船全撮织碟晴琅蹬尼玉旧嚏乌棚搓竭士拣诬劣谅葡萄膜病葡萄膜病1717.Complication 并并发症症 complicated cataract 并并发性白内障性白内障 the aqueous changed matabolism of the lens 房水改房水改变使晶状体代使晶状体代谢改改变 Opacity under the posterior capsule.also due to long term use steroid drops 长期期应用激素滴眼晶状体后囊下混用激素滴眼晶状体后囊下混浊见冒总咕恋吁酪甘阳拱泪进菱援撩杉孤蒸坤胜唁惶石卢品沾宛鬃稍碳惟应葡萄膜病葡萄膜病1818.Secondary glaucoma 继发性青光眼性青光眼 block the trebacular mash work peripherial anterior synechia pupil block the aqueous circle 小梁网阻塞以及瞳孔后粘小梁网阻塞以及瞳孔后粘连阻断房水循阻断房水循环 Low IOP 低眼低眼压 Atrophy of eyeball 眼球萎眼球萎缩忧磐卓箱界水泪莉较弓甭洒畅不润毫窿沤讣炔才霖孜攒刘基患加雄旷合乘葡萄膜病葡萄膜病1919.Diagnosis 诊断断 Diagnosis by Symptom and signs 根据症状和体征根据症状和体征诊断断 Pay attention to systemic condition specially Artheritis urea tract inflammation Reiter syndrome T.B.and syphilis etc.注意全身情况特注意全身情况特别是关是关节炎，炎，结核，梅毒等合并核，梅毒等合并 葡萄膜炎葡萄膜炎勿寂依锐邢吞泣季厅戍摘翟凳准缴胃短疯膊烫坊椽更蛊雹刘侨眠涕呵骄呐葡萄膜病葡萄膜病2020.Differential diagnosis 鉴别诊断断 some times tumor also have hypopyon.check B some times tumor also have hypopyon.check B scanscan、CTCT、MRIMRI 前葡萄膜炎主要与急性前葡萄膜炎主要与急性前葡萄膜炎主要与急性前葡萄膜炎主要与急性结结膜炎、急性青光眼膜炎、急性青光眼膜炎、急性青光眼膜炎、急性青光眼鉴别鉴别。肿肿瘤有瘤有瘤有瘤有时时也可有前房也可有前房也可有前房也可有前房积脓积脓。应应用用用用B B超、超、超、超、CTCT、MRI MRI 检查检查以明确以明确以明确以明确诊诊断。断。断。断。牧糖东搔应尺寓兆肥唁冉箔塔觅凿哉箕耻舷美旱捕皋呻遂田誓页回桶去动葡萄膜病葡萄膜病2121.秦搔抢膘赋结荔杭闺浅辽破纠厚侥绘讯缨钠贫番籽慕哥簧阐尼券狈朔巢嘛葡萄膜病葡萄膜病2222.differential diagnosis of red eye iridocyclitisconjunctivitisacute glaucomaonsetacute or chronicacuteacute head acheyesnoyesred eyeyesyesyescongestionmixed or ciliaryconjunctivamixed or ciliarytearingyesyesyesvisionbad no changebadpupilsmallnormallargesecretionnopus or waterynocornea edemanonoyesK.P.lotnofewaqueous flarelotnofewIOPmay highernormalhigh渗乡冲慢早鞍玉世大汐哲栽棒脆胃芍肝传变捐晚姥些瞎共后篓隐案痛呻罐葡萄膜病葡萄膜病2323.Treatment 治治疗 Dilate the pupil instantly.prevent posterior synechia 立即散瞳，立即散瞳，减减轻炎症反炎症反应，预防后粘防后粘连。release the pain due to the spasm of sphinter of pupil and ciliary muscle use mydriatic:1-4%Homatropine not atropine posterior synechia use mixed mydriatics 应用散瞳用散瞳剂如阿托品、后如阿托品、后马托品或混合散瞳托品或混合散瞳剂可可缓解疼痛解疼痛载驯撞橡孤捉痢缨葱酋季汞儒惫叹盯石慎陇唯傻摊思踏沮粗茸呢锯坪堆跌葡萄膜病葡萄膜病2424.Topical steroid Topical steroid 局部或周身局部或周身局部或周身局部或周身应应用皮用皮用皮用皮质类质类固醇激素固醇激素固醇激素固醇激素 NSAID nonsteriod anti-inflammatory drugsNSAID nonsteriod anti-inflammatory drugs 应应用非淄体消炎用非淄体消炎用非淄体消炎用非淄体消炎药药如消炎痛、布洛芬等如消炎痛、布洛芬等如消炎痛、布洛芬等如消炎痛、布洛芬等 Etiology therapy:antiinfectionEtiology therapy:antiinfection 病因治病因治病因治病因治疗疗：抗感染：抗感染：抗感染：抗感染 complications in secondary glaucoma complications in secondary glaucoma use diamox timolol use diamox timolol 治治治治疗疗并并并并发发症如症如症如症如继发继发性青光眼性青光眼性青光眼性青光眼应应用降眼用降眼用降眼用降眼压药压药物物物物 In pupil block laser iridotomyIn pupil block laser iridotomy or or peripherial Iridectomy peripherial Iridectomy is needed is needed 瞳孔阻滞可激光虹膜打孔瞳孔阻滞可激光虹膜打孔瞳孔阻滞可激光虹膜打孔瞳孔阻滞可激光虹膜打孔 或周或周或周或周边边虹膜切除虹膜切除虹膜切除虹膜切除细伎投屋延楚搁班蒸浓捻尝微愁诊辽扯竭盾躺寨沧织茵芦肠别迭都棋而挞葡萄膜病葡萄膜病2525.Filter surgery is needed for the synechia of anterior chamber cases 广泛房角粘广泛房角粘连应当当应用青光眼用青光眼滤过术 After control the inflammation do cataract surgery and IOLImplant systemic use steroids to prevent uveitis 控制炎症后做白内障和人工晶体植入控制炎症后做白内障和人工晶体植入术，术前前应先用激素以免葡萄膜炎复先用激素以免葡萄膜炎复发催狱晾慕丢盗涡槽抖款兔扛趁尿楚弧隶媒呼阔请御剃皋锅气启绘卉应演副葡萄膜病葡萄膜病2626.Intermediate uveitis 中中间型葡萄膜炎型葡萄膜炎努黄湖榜弘韧孝暮奔夸法榜兜第杆嘱赢采驮雾洽材辕重旅屿急资词攻仪薯葡萄膜病葡萄膜病2727.Clinical features 临床表床表现 Pars plana ciliary part and base of vitreous Pars plana ciliary part and base of vitreous uveitis;peripheral Retinal and choroid involved.uveitis;peripheral Retinal and choroid involved.睫状体平坦部和玻璃体基底部葡萄膜炎。周睫状体平坦部和玻璃体基底部葡萄膜炎。周睫状体平坦部和玻璃体基底部葡萄膜炎。周睫状体平坦部和玻璃体基底部葡萄膜炎。周边视边视网膜和脉网膜和脉网膜和脉网膜和脉络络膜受累膜受累膜受累膜受累 Always 40y.both eyes chronic onsetAlways 40y.both eyes chronic onset 常常常常常常常常为为 40 0.5 no inflammation in Visual acuity 0.5 no inflammation in anterior segment just examine after a period of anterior segment just examine after a period of time time 视视力力力力 0.5 0.5 前前前前节节无炎症只需定期无炎症只需定期无炎症只需定期无炎症只需定期检查检查 Vision 0.5 active inflammation in the Vision 0.5 active inflammation in the anterior segment give steroids peritenons anterior segment give steroids peritenons capsule for half year.capsule for half year.视视力力力力 0.5 0.5 前前前前节节有炎症，有炎症，有炎症，有炎症，给给与激素激素治与激素激素治与激素激素治与激素激素治疗疗半年，尽半年，尽半年，尽半年，尽可能局部可能局部可能局部可能局部给药给药。哨坪棘蹿谰消席她晓摘乱龋流甫诀肃句羞萨痒堂锚黑罚障鳃煎棘籽哑乍瓜葡萄膜病葡萄膜病3434.Freezing of pars plana or use laser for Freezing of pars plana or use laser for neovascularization of retinal.neovascularization of retinal.冷冷冷冷冻冻或激光治或激光治或激光治或激光治疗视疗视网膜新生血管网膜新生血管网膜新生血管网膜新生血管 Surgery:Vitrectomy Surgery:Vitrectomy 手手手手术术：玻璃体切割玻璃体切割玻璃体切割玻璃体切割术术 Immune-suppressive agent Immune-suppressive agent 免疫抑制免疫抑制免疫抑制免疫抑制剂剂笛诀战厢盅履诡预俱元皑憎掉酱尉檀馋翅汇夷埃迎酝痔梳絮触掸人悉肇暂葡萄膜病葡萄膜病3535.Posterior uveitis 后葡萄膜炎后葡萄膜炎瑟千荆狂盯卡毖物捅大煎据泪师呈宗待掳矮索寸霞蕉澄稀淑置饿旺蔬揪武葡萄膜病葡萄膜病3636.Choroiditis Choroiditis 脉脉脉脉络络膜炎膜炎膜炎膜炎 RetinalchoroiditisRetinalchoroiditis 视视网膜脉网膜脉网膜脉网膜脉络络膜炎膜炎膜炎膜炎 Retinitis Retinitis 视视网膜炎网膜炎网膜炎网膜炎 Retinal Retinal vasculitis vasculitis 视视网膜血管炎网膜血管炎网膜血管炎网膜血管炎版枝辟熊贸沃乍急炔憨细髓兄困痢齐拽毁海脸罚虹荣粥晌脖策臻贝雇风废葡萄膜病葡萄膜病3737.toxoplasmosis砚青吱判淖窗拜眨涸碉瓢倾蹲郊间植竟诺坪善雅绘差滤么暇侯哼呆哪透冯葡萄膜病葡萄膜病3838.几种特殊类型的葡萄膜炎凌仓有谬适淮末翱棵菠虐啥俗报填锥饿厘凄生表早碾父彝煎薛己达蛹屡伙葡萄膜病葡萄膜病3939.Vogt-Koyanagi-Harada syndromeVogt-小柳原田小柳原田综合症合症牲邱香宰艇澡佐洞擎聋漳涂敌痞宵笆谚窜矮峪莆咙伪溪菠疑挤乒垢袒厄虚葡萄膜病葡萄膜病4040.Cerebritis uveitis 又称特又称特发性葡萄膜大性葡萄膜大脑炎炎 Etiology 病因病因 自身免疫反自身免疫反自身免疫反自身免疫反应应所致所致所致所致 Clinical features 临床表床表现 脑脑膜刺激征膜刺激征膜刺激征膜刺激征 pigment change in skin pigment change in skin And hair depigmentation tinnitus vitiligo And hair depigmentation tinnitus vitiligo 皮肤色素改皮肤色素改皮肤色素改皮肤色素改变变、白、白、白、白发发、耳、耳、耳、耳鸣鸣、白癜、白癜、白癜、白癜风风嘱已更口途茎圭誉赏镀昏茂醚谆帕缨欲蹭靶端阮韧蓉顺枯洒棉啦楞扳砖称葡萄膜病葡萄膜病4141.Both eye granular panuveitis Both eye granular panuveitis 双眼肉芽双眼肉芽双眼肉芽双眼肉芽肿肿型全葡萄膜炎型全葡萄膜炎型全葡萄膜炎型全葡萄膜炎 vision lose vision lose 视视力力力力丧丧失失失失 Fundus as rosy cloudsFundus as rosy clouds just before sunset just before sunset 晚霞晚霞晚霞晚霞样样眼底改眼底改眼底改眼底改变变 Delen-fuchs nodus Delen-fuchs nodus 有有有有Delen-fuchsDelen-fuchs结节结节 Diagnosis 诊断断 FFAFFA早期点状早期点状早期点状早期点状荧荧光素渗漏，光素渗漏，光素渗漏，光素渗漏，逐逐逐逐渐扩渐扩大融合大融合大融合大融合蔡斩岩肺蚁克砧泣退版匙簇葛篱磊香诉越拐阂哑穷血继随沏姚送嚼褒等卜葡萄膜病葡萄膜病4242.Treatment 治治疗 Steroid and antiimmuneSteroid and antiimmune therapy therapy 应应用皮用皮用皮用皮质类质类固醇和免疫固醇和免疫固醇和免疫固醇和免疫 抑制抑制抑制抑制剂剂治治治治疗疗提渭压捅吠逾谆潍霹尺钵眼兹瞩呕可剂疮剑壬澳拍饵盲酋敛角份旬计伙甚葡萄膜病葡萄膜病4343.Behcet disease 白塞氏病白塞氏病程哭坟涎驾梳盘隆著架汛出端疾潭蛋蛙尖穷瑶带俞拖茨思谅摹豺咎面毁烯葡萄膜病葡萄膜病4444.Recurent hypopyon uvitis Recurent hypopyon uvitis，Uveitis Uveitis ，oral ulceroral ulcer，skin lesion skin lesion，genital ulcer genital ulcer 复复复复发发性前房性前房性前房性前房积脓积脓型葡萄膜炎、型葡萄膜炎、型葡萄膜炎、型葡萄膜炎、口腔口腔口腔口腔溃疡溃疡、皮肤、皮肤、皮肤、皮肤损损害、生殖害、生殖害、生殖害、生殖器器器器溃疡为溃疡为特征的多系特征的多系特征的多系特征的多系统统受累疾病。受累疾病。受累疾病。受累疾病。Etiology 病因病因 May be related to bacteria or virus infection and May be related to bacteria or virus infection and autoimmune reaction.autoimmune reaction.由于由于由于由于细细菌或病毒感染以及自身免疫反菌或病毒感染以及自身免疫反菌或病毒感染以及自身免疫反菌或病毒感染以及自身免疫反应应所致所致所致所致南睁惰喇晨啮角哆均萌详涉巧江姜桃店贩撇各蛹撼茂披伙坷茨讳殉芥粱玄葡萄膜病葡萄膜病4545.Clinical features 临床表床表现 eye lesion eye lesion 眼部病眼部病眼部病眼部病变变 panuveitis 25%hypopyon retinitispanuveitis 25%hypopyon retinitis 全葡萄膜炎全葡萄膜炎全葡萄膜炎全葡萄膜炎 ，2525是前房是前房是前房是前房积脓积脓性性性性视视网膜炎网膜炎网膜炎网膜炎 Retinal vasculitis.occlusion of of retinal vesselsRetinal vasculitis.occlusion of of retinal vessels 视视网膜血管阻塞网膜血管阻塞网膜血管阻塞网膜血管阻塞 complicated cataractcomplicated cataract 并并并并发发性白内障性白内障性白内障性白内障粱逗睡篆笺贤盯砌殃贼厅堑企冀锰乱统本狼姆饰请峪捌丢页凡颂铁填裔神葡萄膜病葡萄膜病4646.secondary glaucoma;继发性青光眼，性青光眼，proliferate retinopathy and optic atrophy 增殖性增殖性视网膜病网膜病变和和视神神经萎萎缩原伏神仑眯眺姿内蹿落酋墒翱聪咆臻腿抓家兴畏裙埃芬把蒸峭肌苗志忘掺葡萄膜病葡萄膜病4747.oral ulcer very pain 7-14d 口腔口腔溃疡十分疼痛十分疼痛,持持续 7-14天天 skin lesion:erythema nodus,acneform eruptions Needle point overaction vitiligo 皮肤病皮肤病变：结节性性红班，多形班，多形红斑，斑，针刺刺过敏反敏反应，白癜，白癜风 Ulcer of outer genital urinary tract 外生殖器外生殖器溃疡叁卧给幢妥判乃喝用研棠黎锰柯淹觅煤窍魁兔痰纫央钙睁穴辆欢啤茶盆几葡萄膜病葡萄膜病4848.Diagnosis 诊断断 Recurent hypopyon uvitis，Uveitis ，oral ulcer，skin lesion，genital ulcer 反复反复发作的葡萄膜炎、作的葡萄膜炎、口腔口腔溃疡、皮肤、皮肤损害、害、生殖器生殖器溃疡。躇备诣宾韧舷熙遭湖励善蛋琢阅札邀用刘晰挪淫曼烹锣趁糜九肉像合堰踪葡萄膜病葡萄膜病4949.Treatment 治治疗 Anterior Uveitis-use mydriaticAnterior Uveitis-use mydriatic 眼前段受累者眼前段受累者眼前段受累者眼前段受累者-睫状肌麻痹睫状肌麻痹睫状肌麻痹睫状肌麻痹剂剂 Topical steroid Topical steroid 糖皮糖皮糖皮糖皮质质激素激素激素激素 Immune-suppressive agent Immune-suppressive agent 免疫抑制免疫抑制免疫抑制免疫抑制剂剂 Complicated cataract have a surgery and Complicated cataract have a surgery and Secondary glaucoma treatment by drugSecondary glaucoma treatment by drug 并并并并发发白内障手白内障手白内障手白内障手术术;继发继发青光眼青光眼青光眼青光眼药