Miserocchi Elisabetta, Modorati Giulio, Di Matteo Federico, Galli Laura, Rama Paolo, Bandello Francesco
Department of Ophthalmology, University Vita-Salute, San Raffaele Scientific Institute, Milan, Italy.
Eur J Ophthalmol. 2011 Nov-Dec;21(6):802-10. doi: 10.5301/EJO.2011.6417.
To analyze risk factors associated with poor visual outcome in patients with ocular sarcoidosis.
In this retrospective study, charts of 44 patients with uveitis and biopsy-proven sarcoidosis were reviewed. Ocular parameters evaluated were as follows: location, type of uveitis, visual acuity, presence of posterior synechia, iris nodules, vitritis, snowballs, chorioretinal lesions, retinal vasculitis, papillitis, macular edema, cataract, and glaucoma. Final visual acuity of the worst-seeing eye at last follow-up was the outcome considered in univariable and multivariable analyses. Visual acuity of the worst-seeing eye was stratified into 2 categories according to the threshold 20/50 (=20/50 and >20/50).
A total of 44 patients with bilateral uveitis were studied. The majority of patients presented with panuveitis (52%), granulomatous type (61%), posterior synechia (62%). The most frequent vision-threatening complications were cystoid macular edema (56%) and cataract (56%). The median best-corrected visual acuity in the worst-seeing eye at presentation and at end of follow-up was respectively 0.4 (interquartile range [IQR] 0.26-0.80) and 0.63 (IQR 0.36-1.00). At univariable analysis, the presence of iris nodules (p=0.049), cystoid macular edema (p=0.007), and cataract (p=0.007) were clinically significant conditions for a visual outcome of 20/50 or worse in the worst-seeing eye. In multivariable analysis, cystoid macular edema (p=0.034) was the only statistically significant predictor associated with unfavorable visual outcome.
In this study, we attempted to find risk factors related to poor visual outcome in patients with ocular sarcoidosis. The results suggest that only the presence of cystoid macular edema was significantly associated with worst visual outcome.
分析眼部结节病患者视力预后不良的相关危险因素。
在这项回顾性研究中，对44例葡萄膜炎且经活检证实为结节病的患者病历进行了回顾。评估的眼部参数如下：部位、葡萄膜炎类型、视力、虹膜后粘连、虹膜结节、玻璃体炎、雪球样病变、脉络膜视网膜病变、视网膜血管炎、视乳头炎、黄斑水肿、白内障和青光眼。最后一次随访时视力最差眼的最终视力是单变量和多变量分析中考虑的结果。视力最差眼的视力根据20/50（=20/50及>20/50）的阈值分为两类。
共研究了44例双侧葡萄膜炎患者。大多数患者表现为全葡萄膜炎（52%）、肉芽肿型（61%）、虹膜后粘连（62%）。最常见的视力威胁性并发症是黄斑囊样水肿（56%）和白内障（56%）。就诊时和随访结束时视力最差眼的最佳矫正视力中位数分别为0.4（四分位间距[IQR]0.26 - 0.80）和0.63（IQR 0.36 - 1.00）。在单变量分析中，虹膜结节（p = 0.049）、黄斑囊样水肿（p = 0.007）和白内障（p = 0.007）是视力最差眼视力为20/50或更差的临床显著相关因素。在多变量分析中，黄斑囊样水肿（p = 0.034）是与不良视力预后相关的唯一具有统计学意义的预测因素。
在本研究中，我们试图找出眼部结节病患者视力预后不良的相关危险因素。结果表明，只有黄斑囊样水肿的存在与最差视力预后显著相关。
