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中间葡萄膜炎的并发症:在短期和长期随访中,其发生率、发病时间以及对视功能的影响。

Complications in Intermediate Uveitis: Prevalence, Time of Onset, and Effects on Vision in Short-Term and Long-Term Follow-Up.

机构信息

a Department of Ophthalmology , Hadassah Medical Center , Jerusalem , Israel.

b Department of Ophthalmology , Rabin Medical Center , Petah Tikva , Israel.

出版信息

Ocul Immunol Inflamm. 2019;27(3):447-455. doi: 10.1080/09273948.2017.1420203. Epub 2018 Jan 25.

DOI:10.1080/09273948.2017.1420203
PMID:29370567
Abstract

: To study the prevalence and time of onset of ocular complications in intermediate uveitis (IU) and to assess their effects on visual outcome in short-term and long-term follow-up. : A retrospective cohort study of patients with IU who had a minimal follow-up of one year. : 96 patients (174 eyes, 70% females) were included with a mean age at presentation of 30 years. Children constituted 38% of all patients. Mean follow- up was 64.9 months. Pars planitis was the most common form followed by sarcoidosis and multiple sclerosis. Cystoid macular edema (CME), cataract, epiretinal membrane and posterior synechiae were the most prevalent complications. Posterior synechiae, band keratopathy, cataract and papillitis at presentation were associated with worse presenting visual acuity (VA). Of the late-onset complications, glaucoma/ocular hypertension (OHT) was the most significantly associated with worse long-term VA. Most sight-threatening complications (namely CME and glaucoma) were diagnosed at presentation while late complications predominantly affected the posterior segment and included among others peripheral retinal elevations, vasoproliferative tumors, and vitreous hemorrhage. Median LogMAR VA improved at short-term and long-term follow-up, from 0.2 to 0.1 (p<0.001). Subgroup analysis revealed significant VA improvement for eyes with all the different complications except for eyes with glaucoma/OHT. : IU is a chronic low-grade uveitis that may be associated with protean early and late complications of the anterior or posterior segments or both. Optimal treatment regimens are imperative for the strict control of inflammation and proper management of complications thus allowing a favorable long-term prognosis.

摘要

: 研究中间葡萄膜炎(IU)的眼部并发症的患病率和发病时间,并评估它们对短期和长期随访中视力结果的影响。 : 一项对 IU 患者进行的回顾性队列研究,这些患者的随访时间至少为一年。 : 共纳入 96 例(174 只眼,70%为女性)患者,发病时的平均年龄为 30 岁。儿童占所有患者的 38%。平均随访时间为 64.9 个月。睫状体平坦部炎是最常见的类型,其次是结节病和多发性硬化症。最常见的并发症是囊样黄斑水肿(CME)、白内障、视网膜前膜和后粘连。发病时的后粘连、带状角膜病变、白内障和视乳头炎与较差的初始视力(VA)相关。在晚期发病的并发症中,青光眼/高眼压(OHT)与长期 VA 最差最相关。大多数威胁视力的并发症(即 CME 和青光眼)在发病时即可诊断,而晚期并发症主要影响后节,包括周边视网膜抬高、血管增生性肿瘤和玻璃体积血等。短期和长期随访的中位 LogMAR VA 均有所改善,从 0.2 提高至 0.1(p<0.001)。亚组分析显示,除了患有青光眼/OHT 的眼睛外,所有其他不同并发症的眼睛的 VA 都有显著改善。 : IU 是一种慢性低度葡萄膜炎,可能与前部或后部或两者的早期和晚期并发症有关。为了严格控制炎症和适当处理并发症,需要制定最佳的治疗方案,从而实现良好的长期预后。

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