神经眼科学性结节病的预后因素和结果。

Prognosis Factors and Outcomes of Neuro-ophthalmologic Sarcoidosis.

机构信息

Département de Médecine Interne et Immunologie Clinique, Sorbonne Université, Centre National De Référence Maladies Autoimmunes Systémiques Rares, Centre National De Référence Maladies Autoinflammatoires et Amylose Inflammatoire. INSERM UMRS 959, Immunologie-Immunopathologie-Immunotherapie, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.

Service De Médecine Interne, Fondation Rothschild, Paris, France.

出版信息

Ocul Immunol Inflamm. 2022 May 19;30(4):821-828. doi: 10.1080/09273948.2020.1834585. Epub 2020 Nov 9.

DOI:10.1080/09273948.2020.1834585

PMID:33166196

Abstract

BACKGROUND

Neuro-ophthalmologic manifestations are uncommon in sarcoidosis. We aim to assess the prognostic factors and outcome of neuro-ophthalmic sarcoidosis.

METHODS

We conducted a multicenter retrospective study on patients with neuro-ophthalmic sarcoidosis. Response to therapy was based on visual acuity, visual field, and orbital MRI exam. Factors associated with remission and relapse were analyzed.

RESULTS

Thirty-five patients [median (IQR) age of 37 years (26.5-53), 63% of women] were included. The diagnosis of sarcoidosis was concomitant of neuro-ophthalmologic symptoms in 63% of cases. Optic neuritis was the most common manifestation. All patients received corticosteroids and 34% had immunosuppressants. At 6 months, 61% improved, 30% were stable, and 9% worsened. Twenty percent of patients had severe visual deficiency at the end of follow-up. Nonresponders patients had significantly worse visual acuity at baseline ( = 0.01). Relapses were less frequent in patients with retro-bulbar optic neuropathy ( = 0.03).

CONCLUSION

Prognosis of neuro-ophthalmic sarcoidosis is poor.

摘要

背景

神经眼科学表现并不常见于结节病。我们旨在评估神经眼型结节病的预后因素和结果。

方法

我们对神经眼型结节病患者进行了一项多中心回顾性研究。根据视力、视野和眼眶 MRI 检查来评估治疗反应。分析了与缓解和复发相关的因素。

结果

共纳入 35 例患者[中位数（IQR）年龄 37 岁（26.5-53 岁），63%为女性]。63%的病例在出现神经眼症状的同时诊断为结节病。视神经炎是最常见的表现。所有患者均接受皮质类固醇治疗，34%的患者接受免疫抑制剂治疗。6 个月时，61%的患者改善，30%的患者稳定，9%的患者恶化。20%的患者在随访结束时存在严重的视力缺陷。无反应者的基线视力明显更差（ = 0.01）。球后视神经炎患者的复发频率较低（ = 0.03）。