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泰国人群中葡萄膜炎相关性青光眼的患病率及视力预后

Prevalence and Visual Outcome of Glaucoma With Uveitis in a Thai Population.

作者信息

Pathanapitoon Kessara, Smitharuck Sarunya, Kunavisarut Paradee, Rothova Aniki

机构信息

*Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand †Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.

出版信息

J Glaucoma. 2017 Mar;26(3):247-252. doi: 10.1097/IJG.0000000000000592.

Abstract

OBJECTIVE

The aim of this study was to report on the prevalence of uveitic secondary glaucoma (USG) and ocular hypertension in patients with uveitis in Thailand, and to identify factors associated with the development of USG and its visual outcome.

DESIGN

This is a retrospective cohort study.

METHODS

We included 174 consecutive uveitis patients (237 affected eyes) visiting the Ophthalmology Department of Chiang Mai University Hospital, Thailand, from January 2013 to March 2013.

RESULTS

The prevalence of USG was 29% (51/174) and that of ocular hypertension was 18% (32/174). The follow-up period ranged from 3 to 96 months (mean±SD=33±21 mo). Characteristics associated with the development of USG were as follows: age at onset of uveitis above 60 years and longer duration of uveitis (P=0.001). No association between location of uveitis and development of USG was observed. Clinical entities associated with the highest prevalence of USG consisted of Posner-Schlossman syndrome and herpetic uveitis. Within the anterior uveitis group, viral etiology was strongly associated with the development of USG, whereas human leukocyte antigen-B27 (HLA-B27)-associated anterior uveitis had lower prevalence of USG than did their HLA-B27-negative counterparts. The prevalence of patients with at least 1 blind eye was significantly higher in those who developed USG (21/51; 41%) than in uveitis patients without glaucoma (22/123; 18%, P=0.001). Characteristics associated with visual loss in USG included poor visual acuity at presentation (P<0.001), and undergoing glaucoma surgery (P<0.05).

CONCLUSIONS

The prevalence of secondary glaucoma among Southeast Asian patients with uveitis was 29%. Blindness in at least 1 eye developed more commonly in patients with USG than in uveitis patients without USG.

摘要

目的

本研究旨在报告泰国葡萄膜炎患者中葡萄膜炎继发性青光眼(USG)和高眼压症的患病率,并确定与USG发生及其视觉预后相关的因素。

设计

这是一项回顾性队列研究。

方法

我们纳入了2013年1月至2013年3月期间连续就诊于泰国清迈大学医院眼科的174例葡萄膜炎患者(237只患眼)。

结果

USG的患病率为29%(51/174),高眼压症的患病率为18%(32/174)。随访期为3至96个月(平均±标准差=33±21个月)。与USG发生相关的特征如下:葡萄膜炎发病年龄在60岁以上且葡萄膜炎病程较长(P=0.001)。未观察到葡萄膜炎部位与USG发生之间的关联。与USG患病率最高相关的临床类型包括波斯纳-施洛斯曼综合征和疱疹性葡萄膜炎。在前葡萄膜炎组中,病毒病因与USG的发生密切相关,而人类白细胞抗原-B27(HLA-B27)相关的前葡萄膜炎患者的USG患病率低于HLA-B27阴性的患者。发生USG的患者中至少有1只眼失明的患病率(21/51;41%)显著高于无青光眼的葡萄膜炎患者(22/123;18%,P=0.001)。与USG视力丧失相关的特征包括就诊时视力差(P<0.001)和接受青光眼手术(P<0.05)。

结论

东南亚葡萄膜炎患者中继发性青光眼的患病率为29%。与无USG的葡萄膜炎患者相比,USG患者中至少1只眼失明更为常见。

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