Durrani O M, Tehrani N N, Marr J E, Moradi P, Stavrou P, Murray P I
Academic Unit of Ophthalmology, Division of Immunity and Infection, Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, City Hospital Dudley Road, Birmingham B18 7QU, UK.
Br J Ophthalmol. 2004 Sep;88(9):1159-62. doi: 10.1136/bjo.2003.037226.
BACKGROUND/AIMS: Uveitis is a major cause of visual morbidity in the working age group. The authors investigated the duration, degree, and causes of visual loss in uveitis patients with the aim of better defining the visual morbidity and identifying potential risk factors.
A retrospective, non-interventional, observational survey of 315 consecutive patients attending a tertiary referral uveitis service.
The mean duration of follow up was 36.7 months. Reduced vision (< or =6/18) was found in 220/315 (69.95%) of the patients with a subset of 120 patients having vision < or =6/60. Unilateral visual loss occurred in 109 (49.54%), while 111 (50.45%) had bilateral loss. The mean duration of visual loss was 21 months. Of the 148 patients with pan-uveitis, 125 (84.45%) had reduced vision, with 66 (53%) having vision < or =6/60. Main causes of visual loss were cystoid macular oedema (CMO) (59/220, 26.8%), cataract (39/220, 17.7%), and combination of CMO and cataract (44/220, 20%). The following were predictive of a poorer visual prognosis: pan-uveitis (p = 0.0005), bilateral inflammation (p = 0.0005), increasing duration of reduced vision (p = 0.0005), an Indian or Pakistani ethnic background (p = 0.004), and increasing patient age (p = 0.02).
Prolonged visual loss occurred in two thirds of uveitis patients, with 70 (22%) patients meeting the criteria for legal blindness at some point in their follow up. Older patients with bilateral inflammation and an increasing duration of reduced vision are at the greatest risk of severe visual loss (< or =6/60). CMO and cataract were responsible for visual loss in 64.5% of patients.
背景/目的：葡萄膜炎是工作年龄组视力损害的主要原因。作者调查了葡萄膜炎患者视力丧失的持续时间、程度和原因，旨在更好地界定视力损害情况并确定潜在危险因素。
对连续就诊于一家三级转诊葡萄膜炎专科的315例患者进行回顾性、非干预性观察性调查。
平均随访时间为36.7个月。在220/315（69.95%）的患者中发现视力下降（≤6/18），其中120例患者视力≤6/60。单侧视力丧失109例（49.54%），双侧视力丧失111例（50.45%）。视力丧失的平均持续时间为21个月。在148例全葡萄膜炎患者中，125例（84.45%）视力下降，其中66例（53%）视力≤6/60。视力丧失的主要原因是黄斑囊样水肿（CMO）（59/220，26.8%）、白内障（39/220，17.7%）以及CMO和白内障合并存在（44/220，20%）。以下因素提示视力预后较差：全葡萄膜炎（p = 0.0005）、双侧炎症（p = 0.0005）、视力下降持续时间延长（p = 0.0005）、印度或巴基斯坦族裔背景（p = 0.004）以及患者年龄增加（p = 0.02）。
三分之二的葡萄膜炎患者出现了长时间的视力丧失，70例（22%）患者在随访的某个阶段符合法定失明标准。年龄较大、患有双侧炎症且视力下降持续时间延长的患者发生严重视力丧失（≤6/60）的风险最高。CMO和白内障导致了64.5%患者的视力丧失。
