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与多发性硬化症相关的葡萄膜炎的特征

Characterisation of uveitis in association with multiple sclerosis.

作者信息

Messenger Wyatt, Hildebrandt Lena, Mackensen Friederike, Suhler Eric, Becker Matthias, Rosenbaum James T

机构信息

Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA.

Department of Ophthalmology, Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg, Germany.

出版信息

Br J Ophthalmol. 2015 Feb;99(2):205-9. doi: 10.1136/bjophthalmol-2014-305518. Epub 2014 Aug 28.

Abstract

PURPOSE

To characterise uveitis in association with multiple sclerosis (MS).

METHODS

We conducted a retrospective chart review of patients with uveitis and MS at two uveitis centres (Portland, Oregon, USA and Heidelberg, Germany). Baseline characteristics and ophthalmic data were collected at the patient's first and last visits. Additionally, neurological records were obtained when possible.

RESULTS

We identified 113 patients (196 eyes) with uveitis and MS. Of these, 53 had a diagnosis of MS confirmed by review of neurological records, 50 additional patients fulfilled the Poser criteria for MS and 10 with MS were referred by an outside neurologist. Among them, 83 (73%) were women and the mean age of presentation was 40.6 years (range 13-64 years). The average visual acuity in affected eyes at presentation was 20/39. There were 90 patients (80%) who presented with intermediate uveitis and 24 patients (15%) with anterior uveitis. Posterior and pan-uveitis were found in four patients (3%) and two patients (2%), respectively. During a median follow-up of 3.2 years (range 0.04-21 years), visual acuity improved -0.09 logMar/year. Compared with our location-matched controls with idiopathic intermediate uveitis (n=16), patients with MS and intermediate uveitis were significantly older when diagnosed with uveitis (p=0.027) and more likely to be female (p=0.01). There was no statistical difference in visual acuity or rate of vision change between our cases and controls (p=0.58 and p=0.36, respectively).

CONCLUSIONS

Uveitis with MS generally presents as intermediate uveitis with a minority presenting with anterior uveitis. Patients are significantly older and more likely to be women than patients with idiopathic intermediate uveitis. The visual prognosis is generally favourable.

摘要

目的

对与多发性硬化症(MS)相关的葡萄膜炎进行特征描述。

方法

我们对两个葡萄膜炎中心(美国俄勒冈州波特兰市和德国海德堡市)患有葡萄膜炎和MS的患者进行了回顾性病历审查。在患者首次和末次就诊时收集基线特征和眼科数据。此外,尽可能获取神经学记录。

结果

我们确定了113例患有葡萄膜炎和MS的患者(196只眼)。其中,53例经神经学记录审查确诊为MS,另有50例患者符合MS的波泽标准,10例患有MS的患者由外部神经科医生转诊。其中,83例(73%)为女性,平均发病年龄为40.6岁(范围13 - 64岁)。发病时患眼的平均视力为20/39。90例患者(80%)表现为中间葡萄膜炎,24例患者(15%)表现为前葡萄膜炎。后葡萄膜炎和全葡萄膜炎分别见于4例患者(3%)和2例患者(2%)。在中位随访3.2年(范围0.04 - 21年)期间,视力每年改善-0.09 logMar。与我们位置匹配的特发性中间葡萄膜炎对照组(n = 16)相比,患有MS和中间葡萄膜炎的患者在诊断葡萄膜炎时年龄显著更大(p = 0.027),且更可能为女性(p = 0.01)。我们的病例组和对照组之间在视力或视力变化率方面无统计学差异(分别为p = 0.58和p = 0.36)。

结论

与MS相关的葡萄膜炎通常表现为中间葡萄膜炎,少数表现为前葡萄膜炎。与特发性中间葡萄膜炎患者相比,这些患者年龄显著更大,且更可能为女性。视力预后总体良好。

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