J Neurosci Res:与母斑病相关的青光眼病理生理学特征及治疗

2018-04-05 cuiguizhong MedSci原创

伊利诺伊大学芝加哥分校的伊利诺伊州眼科和视觉科学学院的Thavikulwat AT近日在J Neurosci Res发表了一篇文章,系统性的总结了与母斑病相关的青光眼病理生理学特征及治疗措施。

伊利诺伊大学芝加哥分校的伊利诺伊州眼科和视觉科学学院的Thavikulwat AT近日在J Neurosci Res发表了一篇文章,系统性的总结了与母斑病相关的青光眼病理生理学特征及治疗措施。

鼻咽恶性肿瘤血管瘤病(ETA; Sturge-Weber综合征),1型神经纤维瘤病(NF1或von Recklinghausen病),Von Hippel-Lindau(VHL)病,结节性硬化症(TSC),皮肤黑素细胞增生症(ODM)和母斑病是一组具有全身或眼部特征性的神经皮肤疾病。通过许多不同的机制,它们可能会导致视神经损伤的青光眼,并伴随轻度到重度的视力丧失。

青光眼通常影响ETA患者(43-72%),眼眶面部1型神经纤维瘤病患者(23-50%)和ODM患者(10%)。在VHL和TSC中可能表现为新生血管性青光眼。在ETA中,青光眼通常与葡萄酒色斑发生在同侧,这是由于GNAQ基因突变引起的。具体而言,前房角的机械性畸形和巩膜外静脉的静脉压升高被认为是ETA诱发青光眼的主要原因。在由NF1肿瘤抑制基因突变引起的NF1中,青光眼通常发生在盖状丛神经纤维瘤的同侧。 NF1患者的眼组织研究揭示,青光眼的发生机制历经神经纤维瘤直接浸润前房,二度角闭合,纤维血管形成和发育角度异常。最后,phakomatosis pigmentovascularis是ODM和葡萄酒色斑的罕见组合。受影响的患者发生青光眼的风险非常高。

尽管有许多不同的青光眼损伤机制,但治疗遵循与先天性青光眼和原发性开角型青光眼治疗相似的方案。一线治疗是局部降压眼药水。对于更严重的病例,可能需要手术治疗,包括小梁切开术、小梁切除术和分流管植入手术等。

原文出处:

Thavikulwat, A.T., et al., Pathophysiology and management of glaucoma associated with phakomatoses. J Neurosci Res, 2018.

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  5. 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  6. 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    2018-04-07 pps20023
  7. 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    2018-04-07 lsndxfj
  8. 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    2018-04-07 三生有幸9135

    学习一下谢谢分享

    0

  9. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Sat Apr 07 06:46:22 CST 2018, time=2018-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=303436, encodeId=f84230343685, content=谢谢了.学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=30331616752, createdName=txqjm, createdTime=Sat Apr 07 06:35:02 CST 2018, time=2018-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=303255, encodeId=76b130325506, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/07/a9772c74ffd6edc03a7f9af07b4747f6.jpg, createdBy=b3722138742, createdName=sunfeifeiyang, createdTime=Fri Apr 06 09:30:44 CST 2018, time=2018-04-06, status=1, ipAttribution=)]
    2018-04-07 txqjm

    谢谢了.学习

    0

  10. 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    2018-04-06 sunfeifeiyang

    0