Santín M, Badrinas F, Mascaró J, Nolla J M, Pujol O, Roca G, Valverde J, Mañá J, Fernández-Nogués F
Servicio de Medicina Interna, Hospital de Bellvitge-Prínceps d'Espanya, Barcelona.
Med Clin (Barc). 1991 May 4;96(17):641-4.
To evaluate the usefulness of a systematic study of patients with uveitis and to assess the associated systemic diseases.
200 patients seen in an outpatient clinic for the evaluation of uveitis between 1981 and 1988 were included in the study. Patients with eye disease associated with drug abuse or human immunodeficiency virus were excluded. The study protocol included an initial clinical and ophthalmological evaluation followed by selected specific investigations.
Anatomical localization: anterior uveitis 122 (61%), posterior 41 (20.5%), panuveitis 30 (15%) and intermediate 7 (3.5%).
74 cases (37%) were secondary, 101 (50.5%) were idiopathic, and 25 (12.5%) were specific syndromes of uveitis of unknown cause. Toxoplasmosis was the most common cause of infective uveitis, and ankylosing spondylitis was the most common noninfective cause. Diagnostic process: group 1, diagnosed by the ophthalmological investigation (25 cases); group 2, diagnosed on the basis of the accompanying clinical features and/or specific investigations (66 cases); and group 3, diagnosed by wider detection methods (8 cases).
There was a remarkably high rate uveitis without etiological diagnosis. The evaluation of patients with uveitis requires a careful evaluation of ocular and systemic features, followed by selected specific investigation. The indiscriminate use of diagnostic tests is not warranted.
评估对葡萄膜炎患者进行系统研究的实用性,并评估相关的全身性疾病。
本研究纳入了1981年至1988年间在门诊接受葡萄膜炎评估的200例患者。排除与药物滥用或人类免疫缺陷病毒相关的眼部疾病患者。研究方案包括初步的临床和眼科评估,随后进行选定的特定检查。
解剖定位:前葡萄膜炎122例(61%),后葡萄膜炎41例(20.5%),全葡萄膜炎30例(15%),中间葡萄膜炎7例(3.5%)。
74例(37%)为继发性,101例(50.5%)为特发性,25例(12.5%)为病因不明的特定葡萄膜炎综合征。弓形虫病是感染性葡萄膜炎最常见的病因,强直性脊柱炎是最常见的非感染性病因。诊断过程:第1组,通过眼科检查确诊(25例);第2组,根据伴随的临床特征和/或特定检查确诊(66例);第3组,通过更广泛的检测方法确诊(8例)。
病因未明的葡萄膜炎发生率非常高。对葡萄膜炎患者的评估需要仔细评估眼部和全身特征,随后进行选定的特定检查。不应滥用诊断测试。