Медицинская иммунология (Jan 2021)
Features of ophthalmic pathology in autoimmune diseases
Abstract
Incidence of the ophthalmic complications in autoimmune diseases is stably increasing over recent years, as well as overall increase in the number of autoimmune pathologies around the world, along with novel diagnostic approaches. According to the WHO estimates, the number of patients with visual impairment is estimated at 285 million people for 2010, causing blindness in 39 million cases. Among autoimmune diseases, diabetes mellitus, sarcoidosis and Behcet’s disease are most often complicated by these conditions. Dry eye syndrome is the most common eye complication associated with these diseases. Our aim was to describe eye complications in type I diabetes, sarcoidosis, and Behcet’s disease, as well as show the importance of research in the area, and to develop common criteria for the care of patients with ophthalmic conditions. The review considers main pathogenetic links, ethnic and genetic factors of ocular pathologies in autoimmune disorders, the main issues of timely diagnosis and the use of various schemes of conservative therapy. The results obtained upon analysis of the literature contain demonstrate the possible autoimmune nature of such eye pathologies, as uveitis and dry eye syndrome in diseases such as type 1 diabetes mellitus, sarcoidosis, and Behcet’s disease. Despite the ongoing research, there are many unresolved issues in the study of pathogenesis, as well as in therapeutic strategy. Therefore, the treatment of autoimmune eye diseases is a difficult task today, including treatment of the underlying disease, and local therapy of the visual organ. Since the primary immunopathology in the mentioned autoimmune diseases requires further studies, it is not possible to accurately predict the course of eye disease, possible complications and outcomes at the present time. Currently, there is only scarce information for creating uniform criteria for the treatment of uveitis and dry eye syndrome in autoimmune diseases. Their further development can contribute to establishment of the principles of medical care, in order to improve efficiency of treatment and quality of life in the patients. Further research and accumulation of data in the field are needed.
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