目的:本研究的目的是阐明IgG4相关眼科疾病(IgG4-ROD)的临床特征和症状。
方法:回顾性,多中心研究。
方法:回顾了日本9家医院诊断的378例IgG4-ROD患者的病历。人口概况,临床发现,并对患者的眼部症状进行分析。
结果:根据IgG4-ROD的诊断标准,261例患者(69%)诊断明确,45例患者(12%)可能,72例患者(19%)可能。诊断时患者的平均年龄为60.6±13.9岁;男性195人(52%)。初始诊断时的平均IgG4血清水平为578.9mg/dL。影像学检查显示病理性病变如下:泪腺病变(86%),眼外肌(21%),三叉神经(20%),和眼睑(12%);孤立的眼眶肿块(11%);弥漫性眼眶病变(8%);视神经周围病变(8%);巩膜病变(1%)。眼科症状包括干眼症(22%),复视(20%),视力下降(8%),和视野缺陷(5%)。在182例患者(48%)中观察到具有眼外病变的IgG4-ROD。
结论:尽管众所周知泪腺是IgG4-ROD的主要病理部位,各种眼组织可能受到影响并引起包括视力丧失在内的眼科症状。
OBJECTIVE: The aim of this
study was to elucidate the clinical features and symptoms of IgG4-related ophthalmic disease (IgG4-ROD).
METHODS: Retrospective, multicenter
study.
METHODS: The medical charts of 378 patients with IgG4-ROD diagnosed at 9 hospitals in Japan were reviewed. The demographic profiles, clinical findings, and ocular symptoms of the patients were analyzed.
RESULTS: On the basis of the diagnostic criteria for IgG4-ROD, the diagnosis was definite in 261 patients (69%), probable in 45 patients (12%), and possible in 72 patients (19%). The patients\' mean age at the time of diagnosis was 60.6 ± 13.9 years; 195 (52%) were male. The mean IgG4 serum level at the time of the initial diagnosis was 578.9 mg/dL. Imaging studies showed pathologic lesions as follows: lesions in the lacrimal glands (86%), extraocular muscles (21%), trigeminal nerve (20%), and eyelids (12%); isolated orbital mass (11%); diffuse orbital lesion (8%); lesion in the perioptic nerve (8%); and lesion in the sclera (1%). The ophthalmic symptoms included dry eye (22%), diplopia (20%), decreased vision (8%), and visual field defects (5%). IgG4-ROD with extraocular lesions was observed in 182 patients (48%).
CONCLUSIONS: Although the lacrimal glands are well known to be the major pathologic site of IgG4-ROD, various ocular tissues can be affected and cause ophthalmic symptoms including visual loss.