青少年特发性关节炎患者的慢性非感染性葡萄膜炎
Chronic Non-infectious Uveitis in Patients with Juvenile Idiopathic Arthritis.
作者信息
Kolomeyer Anton M, Tu Yufei, Miserocchi Elisabetta, Ranjan Mangala, Davidow Amy, Chu David S
机构信息
a Department of Ophthalmology , University of Pittsburgh Medical Center , Pittsburgh , Pennsylvania , USA.
b Institute of Ophthalmology and Visual Science , Rutgers University , Newark , New Jersey , USA.
出版信息
Ocul Immunol Inflamm. 2016 Aug;24(4):377-85. doi: 10.3109/09273948.2015.1125509. Epub 2016 Feb 22.
PURPOSE
To describe clinical findings and analyze treatment evolution of chronic, non-infectious uveitis in patients with juvenile idiopathic arthritis (JIA).
METHODS
A total of 82 patients (147 eyes) with JIA-related uveitis treated for ≥2 months were included (78% females; 79% bilateral uveitis; 74% anterior uveitis). Outcome measures were visual acuity (VA), inflammation control, side-effects, and surgical procedures.
RESULTS
Mean ± SD age at diagnosis was 4.9 ± 3.8 years; mean ± SD follow-up time was 8.7 ± 7.8 years. Mean VA did not significantly change throughout the study. Three (2%) eyes resulted in no light perception (NLP) vision. Thirty (37%) patients underwent 69 procedures. In total, 41 (50%) patients achieved inflammation control. TNF-α inhibitors were significantly associated with inflammation control. Seven (8.5%) patients stopped treatment due to side-effects.
CONCLUSIONS
JIA is a cause of significant ocular morbidity. TNF-α inhibitor use was associated with inflammation control. Prospective, randomized, double blind clinical trials in this regard are warranted.
目的
描述青少年特发性关节炎（JIA）患者慢性非感染性葡萄膜炎的临床特征并分析治疗进展。
方法
纳入82例（147只眼）接受治疗≥2个月的JIA相关性葡萄膜炎患者（78%为女性；79%为双侧葡萄膜炎；74%为前葡萄膜炎）。观察指标包括视力（VA）、炎症控制情况、副作用及手术治疗情况。
结果
诊断时的平均年龄±标准差为4.9±3.8岁；平均随访时间±标准差为8.7±7.8年。在整个研究过程中，平均视力无显著变化。3只眼（2%）最终无光感（NLP）视力。30例（37%）患者接受了69次手术。总计41例（50%）患者实现了炎症控制。肿瘤坏死因子-α（TNF-α）抑制剂与炎症控制显著相关。7例（8.5%）患者因副作用停止治疗。
结论
JIA是导致严重眼部疾病的原因之一。使用TNF-α抑制剂与炎症控制相关。在这方面有必要进行前瞻性、随机、双盲临床试验。
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