Abstract:
Glaucoma is a leading cause of irreversible blindness worldwide, caused by the gradual degeneration of retinal ganglion cells and their axons. While glaucoma is primarily considered a genetic and age-related disease, some inflammatory conditions, such as uveitis and viral-induced anterior segment inflammation, cause secondary or uveitic glaucoma. Viruses are predominant ocular pathogens and can impose both acute and chronic pathological insults to the human eye. Many viruses, including herpes simplex virus, varicella-zoster virus, cytomegalovirus, rubella virus, dengue virus, chikungunya virus, Ebola virus, and, more recently, Zika virus (ZIKV) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), have been associated with sequela of either primary or secondary glaucoma. Epidemiological and clinical studies suggest the association between these viruses and subsequent glaucoma development. Despite this, the ocular manifestation and sequela of viral infections are not well understood. In fact, the association of viruses with glaucoma is considered relatively uncommon in part due to underreporting and/or lack of long-term follow-up studies. In recent years, literature on the pathological spectrum of emerging viral infections, such as ZIKV and SARS-CoV-2, has strengthened this proposition and renewed research activity in this area. Clinical studies from endemic regions as well as laboratory and preclinical investigations demonstrate a strong link between an infectious trigger and development of glaucomatous pathology. In this article, we review the current understanding of the field with a particular focus on viruses and their association with the pathogenesis of glaucoma.
摘要:
青光眼是全球不可逆失明的主要原因,由视网膜神经节细胞及其轴突的逐渐变性引起。虽然青光眼主要被认为是一种遗传和年龄相关的疾病,一些炎症,如葡萄膜炎和病毒引起的眼前节炎症,引起继发性或葡萄膜性青光眼。病毒是主要的眼部病原体,并且可以对人眼施加急性和慢性病理性损害。许多病毒,包括单纯疱疹病毒,水痘-带状疱疹病毒,巨细胞病毒,风疹病毒,登革热病毒,基孔肯雅病毒,埃博拉病毒,and,最近,寨卡病毒(ZIKV)和严重急性呼吸道综合症冠状病毒-2(SARS-CoV-2),与原发性或继发性青光眼的后遗症有关。流行病学和临床研究表明,这些病毒与随后的青光眼发展之间存在关联。尽管如此,病毒感染的眼部表现和后遗症尚不清楚。事实上,病毒与青光眼的关联被认为相对少见,部分原因是漏报和/或缺乏长期随访研究.近年来,关于新出现的病毒感染的病理谱的文献,ZIKV和SARS-CoV-2等,加强了这一主张,并更新了该领域的研究活动。来自流行地区的临床研究以及实验室和临床前研究表明,感染性触发因素与青光眼病理发展之间存在很强的联系。在这篇文章中,我们回顾了目前对该领域的理解,特别关注病毒及其与青光眼发病机制的关系。