Moorfields Eye Hospital, London, United Kingdom; Institute of Ophthalmology, University College of London, London, United Kingdom.
Institute of Ophthalmology, University College of London, London, United Kingdom.
Ophthalmology. 2014 Dec;121(12):2387-92. doi: 10.1016/j.ophtha.2014.07.007. Epub 2014 Aug 30.
To evaluate the long-term clinical and functional outcome, risks, and causes of vision loss and burden of disease among patients with uveitis.
Cross-sectional study.
The study included 1076 patients diagnosed with uveitis who attended the uveitis clinic at Moorfields Eye Hospital, London, United Kingdom, between 2011 and 2013.
Information was gathered from the notes of all patients who were examined in the clinic.
Best-corrected visual acuity (BCVA), causes of moderate vision loss (MVL; 20/50-20/120), and severe vision loss (SVL; ≤ 20/200).
The study included 1799 eyes of 1076 patients with an average follow-up of 7.97 ± 0.17 years (median, 5.6 years; range, 1 month-54 years; 8159 patient-years; 14 226 eye-years). Average BCVA remained stable for patients with anterior uveitis (20/30 at baseline to 20/33 at 10 years), as well as for those with nonanterior uveitis (20/50 at baseline to 20/47 at 10 years). Vision loss was noted in 19.2% of eyes, with an incidence for MVL of 0.01 per eye-year or 0.02 per patient-year and for SVL of 0.01 per eye-year or 0.02 per patient-year. Patients were more at risk of vision loss if they had non-anterior uveitis disease, vitreous opacities, retinal detachment, cystoid macular edema (CME), macular scarring, macular hole, optic neuropathy, or macular ischemia. Chronic CME was the most common cause of MVL (3.55%), and macular scarring was the most common cause for irreversible SVL (4%). Among 525 patients (48.7%) who received oral prednisolone, 320 (61%) required a dose of more than 40 mg/day and 130 (24.8%) also required 1 or more second-line agents. Patients were reviewed on average 33.7 ± 0.7 times or 5.9 ± 0.46 times/year.
Long-term functional outcome among uveitis patients is good, with BCVA remaining stable for more than 10 years of follow-up. In cases when vision loss occurs, it is related mainly to retinal changes. The burden on clinical services is similar regardless of the severity of disease or the risk of vision loss.
评估葡萄膜炎患者的长期临床和功能结果、风险以及视力丧失和疾病负担的原因。
横断面研究。
该研究纳入了 2011 年至 2013 年期间在英国伦敦 Moorfields 眼科医院葡萄膜炎诊所就诊的 1076 名确诊为葡萄膜炎的患者。
从所有在诊所接受检查的患者的病历中收集信息。
最佳矫正视力（BCVA）、中度视力丧失（MVL；20/50-20/120）和严重视力丧失（SVL；≤20/200）的原因。
该研究纳入了 1076 名患者的 1799 只眼，平均随访时间为 7.97±0.17 年（中位数为 5.6 年；范围为 1 个月-54 年；8159 患者年；14226 眼年）。前葡萄膜炎患者（基线时为 20/30，10 年后为 20/33）和非前葡萄膜炎患者（基线时为 20/50，10 年后为 20/47）的 BCVA 保持稳定。19.2%的眼出现视力丧失，MVL 的发病率为 0.01 眼年/0.02 患者年，SVL 的发病率为 0.01 眼年/0.02 患者年。如果患者患有非前部葡萄膜炎疾病、玻璃体混浊、视网膜脱离、囊样黄斑水肿（CME）、黄斑瘢痕、黄斑裂孔、视神经病变或黄斑缺血，那么他们发生视力丧失的风险更高。慢性 CME 是 MVL（3.55%）最常见的原因，而黄斑瘢痕是不可逆 SVL（4%）最常见的原因。在接受口服泼尼松龙治疗的 525 名患者（48.7%）中，320 名（61%）需要超过 40mg/天的剂量，130 名（24.8%）还需要 1 种或多种二线药物。患者平均接受 33.7±0.7 次或 5.9±0.46 次/年的检查。
葡萄膜炎患者的长期功能预后良好，BCVA 在 10 年以上的随访中保持稳定。如果出现视力丧失，主要与视网膜变化有关。无论疾病严重程度或视力丧失风险如何，对临床服务的负担相似。
