Gallagher Kevin, Viswanathan Ananth, Okhravi Narciss
Moorfields Eye Hospital National Health Society Foundation Trust, London, England2Department of Undergraduate Education, Moorfields Eye Hospital National Health Society Foundation Trust, London, England.
Moorfields Eye Hospital National Health Society Foundation Trust, London, England3National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital National Health Society Foundation Trust, London, England4University College Londo.
JAMA Ophthalmol. 2015 Oct;133(10):1190-3. doi: 10.1001/jamaophthalmol.2015.2249.
Systemic lupus erythematosus (SLE) can be associated with uveitis. The reported prevalence of SLE in patients with uveitis varies from 0.1% to 4.8%. Accordingly, the positive predictive value of antinuclear antibody testing in diagnosing SLE in a patient with uveitis varies enormously. An accurate estimate of SLE prevalence in uveitis is needed to establish the value of routine antinuclear antibody testing in patients with uveitis.
A literature review using the Medline database was performed to find studies reporting data on uveitis etiology from January 1, 1984, to March 20, 2015. Studies were included where there were sufficient data to draw conclusions on the prevalence of SLE as an etiological factor in uveitis. Data for 53 315 patients were reviewed and 63 studies from 30 countries were included. The prevalence of SLE as a cause of uveitis was estimated to be 0.47% (95% CI, 0.41%-0.53%). The positive predictive value of routine antinuclear antibody testing was 2.9% (95% CI, 2.65%-3.19%).
Systemic lupus erythematosus is a rare cause of uveitis. Routine antinuclear antibody testing has a low positive predictive value for SLE. These data suggest such testing should be reserved for patients where there is a higher pretest probability of SLE.
系统性红斑狼疮（SLE）可伴有葡萄膜炎。据报道，葡萄膜炎患者中SLE的患病率在0.1%至4.8%之间。因此，抗核抗体检测在诊断葡萄膜炎患者SLE时的阳性预测值差异极大。需要准确估计葡萄膜炎中SLE的患病率，以确定葡萄膜炎患者常规抗核抗体检测的价值。
利用Medline数据库进行文献综述，以查找1984年1月1日至2015年3月20日期间报告葡萄膜炎病因数据的研究。纳入有足够数据可就SLE作为葡萄膜炎病因因素的患病率得出结论的研究。对53315例患者的数据进行了审查，并纳入了来自30个国家的63项研究。SLE作为葡萄膜炎病因的患病率估计为0.47%（95%CI，0.41%-0.53%）。常规抗核抗体检测的阳性预测值为2.9%（95%CI，2.65%-3.19%）。
系统性红斑狼疮是葡萄膜炎的罕见病因。常规抗核抗体检测对SLE的阳性预测值较低。这些数据表明，此类检测应仅用于SLE预测试概率较高的患者。
