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土耳其结节病性葡萄膜炎患者的转诊模式、人口统计学和临床特征以及视力预后

Referral patterns, demographic and clinical features, and visual prognosis of Turkish patients with sarcoid uveitis.

作者信息

Tugal-Tutkun Ilknur, Aydin-Akova Yonca, Güney-Tefekli Esra, Aynaci-Kahraman Burcu

机构信息

Istanbul Faculty of Medicine, Department of Ophthalmology, Istanbul University, Istanbul, Turkey.

出版信息

Ocul Immunol Inflamm. 2007 Jul-Aug;15(4):337-43. doi: 10.1080/09273940701375402.

Abstract

The purpose of this study was to investigate the referral patterns, demographic and clinical features, and visual prognosis of patients with sarcoid uveitis seen at 2 tertiary eye care centers in Turkey. A retrospective study was made of 44 patients with uveitis associated with biopsy-confirmed or presumed sarcoidosis. Thirty-four patients (77%) were female and 10 (23%) were male. The mean age at onset of uveitis was 39.8 years. Twenty-seven patients (61%) were referred without a diagnosis of sarcoidosis and 17 (39%) patients were referred with a diagnosis of systemic sarcoidosis. The duration of uveitis prior to referral was 2-15 years in 52% of the patients in the former group. At presentation, 37 patients (84%) had bilateral and 7 patients (16%) had unilateral uveitis, and 17 patients (39%) had only anterior uveitis. The most common ocular findings were granulomatous keratic precipitates, persistent posterior synechiae, and snowball vitreous opacities. Kaplan-Meier survival analysis estimated the risk of recurrence as 30% at 6 months and 61% at 5 years. New complications developed in 18 patients. Potential visual acuity was better than 0.4 in 80% of eyes. The estimated risk of losing potential visual acuity by at least 2 lines was 7% at 6 months and 43% at 5 years. None of the eyes lost useful vision (> 0.1) under the authors' care. The referral patterns suggest underrecognition of sarcoidosis as a cause of uveitis in Turkey. The demographic and clinical features of these patients were mostly similar to those reported from other countries, suggesting that the diagnosis may not be difficult in Turkish patients but requires an increased awareness of the disease in this population.

摘要

本研究旨在调查在土耳其两家三级眼科护理中心就诊的结节病性葡萄膜炎患者的转诊模式、人口统计学和临床特征以及视力预后。对44例经活检确诊或疑似结节病的葡萄膜炎患者进行了回顾性研究。34例患者(77%)为女性,10例(23%)为男性。葡萄膜炎发病的平均年龄为39.8岁。27例患者(61%)在未诊断为结节病的情况下被转诊,17例(39%)患者在诊断为系统性结节病后被转诊。前一组中52%的患者在转诊前葡萄膜炎的病程为2至15年。就诊时,37例患者(84%)患有双侧葡萄膜炎,7例患者(16%)患有单侧葡萄膜炎,17例患者(39%)仅患有前葡萄膜炎。最常见的眼部表现为肉芽肿性角膜后沉着物、持续性虹膜后粘连和雪球样玻璃体混浊。Kaplan-Meier生存分析估计,6个月时复发风险为30%,5年时为61%。18例患者出现了新的并发症。80%的眼睛潜在视力优于0.4。6个月时视力至少下降2行的估计风险为7%,5年时为43%。在作者的治疗下,没有一只眼睛丧失有用视力(>0.1)。转诊模式表明,在土耳其结节病作为葡萄膜炎病因的认识不足。这些患者的人口统计学和临床特征大多与其他国家报道的相似,这表明土耳其患者的诊断可能并不困难,但需要提高该人群对该病的认识。

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