Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
Mediators Inflamm. 2020 May 15;2020:6872402. doi: 10.1155/2020/6872402. eCollection 2020.
To examine demographic and clinical characteristics and long-term visual outcome in a cohort of Italian patients affected by Behçet's uveitis (BU).
Retrospective chart review of 47 patients with BU attending our unit between January 2018 and December 2019. Ophthalmologic manifestations, best-corrected visual acuity (BCVA), fluoroangiography and optical coherence tomography findings, and ocular complications were recorded. Predictive factors of a poor visual outcome and long-term complications were also investigated.
Forty-seven patients (23 males and 24 females) for a total of 84 eyes were enrolled. Uveitis was bilateral in 37 (78.7%) patients with panuveitis being the most frequent anatomical pattern (40 out of 84 eyes), whereas 27 eyes presented a posterior uveitis. Isolated anterior uveitis was detected in 16 eyes. A significant improvement of median BCVA between baseline and last follow-up values was detected ( = 0.042). A higher risk of poor visual prognosis was observed in patients with uveitis duration greater than 15 years ( = 0.019). A significant resolution of retinal vasculitis was detected between baseline and last follow-up evaluation ( < 0.0001) whereas the mean ± SD macular thickness did not decrease significantly between baseline (376.00 ± 97.45 m) and last follow-up evaluation (338.08 ± 55.81 m). Forty-two eyes developed 57 complications during the disease course. Cataract was the most frequent ( = 12), followed by epiretinal membranes ( = 11) and cystoid macular edema ( = 6). The following variables were identified as predictors of long-term complications: human leukocyte antigen- (HLA-) B51 ( = 0.006), panuveitis ( = 0.037), and a uveitis duration of more than 15 years ( = 0.049).
In Italian patients, BU typically arises in the third decade and predominantly manifests as a bilateral posterior uveitis or panuveitis. Its duration is associated with a poor visual prognosis. Uveitis duration, the presence of HLA-B51, and panuveitis are predictors of long-term structural complications, thus representing main drivers in the treatment decision-making.
研究意大利一组贝切特葡萄膜炎（BU）患者的人口统计学和临床特征及长期视力结果。
回顾性分析 2018 年 1 月至 2019 年 12 月期间在我们单位就诊的 47 例 BU 患者的病历。记录眼部表现、最佳矫正视力（BCVA）、荧光血管造影和光学相干断层扫描结果以及眼部并发症。还研究了视力不良和长期并发症的预测因素。
共纳入 47 例患者（23 名男性和 24 名女性），共 84 只眼。37 例（78.7%）患者的葡萄膜炎为双眼性，最常见的解剖类型为全葡萄膜炎（84 只眼中有 40 只），27 只眼为后葡萄膜炎。16 只眼为单纯前葡萄膜炎。中位 BCVA 在基线和最后随访值之间有显著改善（ = 0.042）。葡萄膜炎持续时间大于 15 年的患者视力预后不良的风险更高（ = 0.019）。基线和最后随访评估之间视网膜血管炎显著缓解（ < 0.0001），而黄斑厚度的平均值 ± SD 无明显变化（基线时为 376.00 ± 97.45 μm，最后随访时为 338.08 ± 55.81 μm）。42 只眼在疾病过程中出现 57 种并发症。白内障最常见（ = 12），其次是视网膜内膜（ = 11）和囊样黄斑水肿（ = 6）。以下变量被确定为长期并发症的预测因素：人类白细胞抗原（HLA）-B51（ = 0.006）、全葡萄膜炎（ = 0.037）和葡萄膜炎持续时间超过 15 年（ = 0.049）。
在意大利患者中，BU 通常发生在 30 岁出头，主要表现为双侧后葡萄膜炎或全葡萄膜炎。其持续时间与视力预后不良有关。葡萄膜炎持续时间、HLA-B51 存在和全葡萄膜炎是长期结构并发症的预测因素，因此是治疗决策中的主要驱动因素。
