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意大利北部一家三级转诊中心葡萄膜炎模式的变化:对990例连续病例的分析。

Changes in patterns of uveitis at a tertiary referral center in Northern Italy: analysis of 990 consecutive cases.

作者信息

Luca Cimino, Raffaella Aldigeri, Sylvia Marchi, Valentina Mastrofilippo, Fabiana Viscogliosi, Marco Coassin, Annamaria Soldani, Luisa Savoldi, Alessandro De Fanti, Lucia Belloni, Alessandro Zerbini, Maria Parmeggiani, Matthew Chersich, Alessandra Soriano, Carlo Salvarani, Luigi Fontana

机构信息

Immunology Eye Unit, Eye Department, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy.

Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.

出版信息

Int Ophthalmol. 2018 Feb;38(1):133-142. doi: 10.1007/s10792-016-0434-x. Epub 2017 Jan 9.

Abstract

PURPOSE

The role of uveitis, an uncommon ocular disease, is often neglected in research and treatment of autoimmune conditions. The study described the spectrum of uveitis at a referral center in North Italy, and compared that to a previously published series of patients.

METHODS

We reviewed all patients with uveitis diagnosed from 2013 to 2015 at the Immunology Eye Unit, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy. We examined patient characteristics, disease spectrum, and etiologies.

RESULTS

In total, 990 cases of uveitis were identified, who were mostly female (59%) with a median age at presentation of 44 years (interquartile range = 29-57). Anterior uveitis was most frequent (53.5%), followed by panuveitis (22.8%), posterior (16.2%), and intermediate uveitis (5.5%). Anterior herpetic uveitis (15.6%), Fuchs uveitis (9.7%), and HLA-B27 positive anterior uveitis (7.7%) were the most common specific diagnoses. Compared with the previous series, we observed an increased incidence of uveitis, and a different pattern of diagnoses. Rates of herpetic, HLA-B27 positive uveitis, and presumed ocular tuberculosis were higher, but Fuchs uveitis was less frequent.

CONCLUSIONS

The pattern of uveitis appears to be changing, very likely due to population-level increases in infectious diseases, to the availability of new diagnostic tests and to the interdisciplinary approach used in patient diagnosis.

摘要

目的

葡萄膜炎是一种罕见的眼部疾病,在自身免疫性疾病的研究和治疗中其作用常常被忽视。本研究描述了意大利北部一家转诊中心的葡萄膜炎谱,并将其与先前发表的一系列患者情况进行比较。

方法

我们回顾了2013年至2015年在意大利雷焦艾米利亚市圣玛丽亚新医院免疫眼科确诊的所有葡萄膜炎患者。我们检查了患者特征、疾病谱和病因。

结果

共确诊990例葡萄膜炎患者,其中大多数为女性(59%),就诊时的中位年龄为44岁(四分位间距=29 - 57岁)。前葡萄膜炎最为常见(53.5%),其次是全葡萄膜炎(22.8%)、后葡萄膜炎(16.2%)和中间葡萄膜炎(5.5%)。前疱疹性葡萄膜炎(15.6%)、富克斯葡萄膜炎(9.7%)和HLA - B27阳性前葡萄膜炎(7.7%)是最常见的具体诊断类型。与先前系列相比,我们观察到葡萄膜炎发病率增加,且诊断模式不同。疱疹性、HLA - B27阳性葡萄膜炎以及疑似眼结核的发病率较高,但富克斯葡萄膜炎的发病率较低。

结论

葡萄膜炎的模式似乎正在发生变化,很可能是由于传染病在人群层面的增加、新诊断测试的可用性以及患者诊断中采用的跨学科方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8775/5876414/b1c792cf6139/10792_2016_434_Fig1_HTML.jpg

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