Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul Korea.
Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Korean J Ophthalmol. 2021 Feb;35(1):64-72. doi: 10.3341/kjo.2020.0131. Epub 2020 Dec 11.
To describe the clinical characteristics and treatment outcomes of uveitis in patients with psoriasis in Korea.
The medical records of 20 patients (27 eyes) with psoriatic uveitis in two tertiary hospitals were retrospectively reviewed. We analyzed data about patient demographics, uveitis types, laterality, onset of disease, human leukocyte antigen (HLA) types, intraocular pressure, visual acuity, comorbidities, and medical treatments and outcomes for uveitis and psoriasis.
The cohort comprised 11 males and nine females (age of onset, 50.1 ± 13.2 years) and the mean follow-up period was 3.9 ± 4.0 years. Types of uveitis included anterior (85%), intermediate (10%), and panuveitis (5%). A total of 13 (65%) cases presented with unilateral involvement and 12 out of 18 patients (66.7%) were positive for HLA-B27. The average intraocular pressure of affected eyes was 11.6 ± 3.6 at the first visit and 13.8 ± 3.6 mmHg at the final visit. The average logarithm of the minimum angle of resolution visual acuity of affected eyes at the initial examination was 0.16 ± 0.52 and 0.27 ± 0.71 at the last examination. Most common comorbidity (13 patients, 65%) was psoriatic arthritis (PsA). All cases underwent topical corticosteroid treatment; however, 11 (55%) required systemic corticosteroid and immunosuppressants for the treatment of uveitis. Notable deterioration in visual outcome was found in two cases (10%) due to severe intraocular inflammation and its complications (uveitic glaucoma and bullous keratopathy). Recurrent uveitis was observed in 57.9% of patients. Patients with PsA tended to have higher positive rate of HLA-B27 (83.3%). However, there was no significant correlation between visual prognosis and location of psoriatic uveitis, presence of PsA, and HLA-B27 positivity.
Psoriatic uveitis in Koreans usually presents with anterior uveitis with unilateral involvement. PsA was the most common comorbidity. In majority of patients, visual outcomes are satisfactory with appropriate topical or systemic immunosuppressive treatment.
描述韩国银屑病患者葡萄膜炎的临床特征和治疗结果。
回顾了两家三级医院 20 名（27 只眼）银屑病性葡萄膜炎患者的病历。我们分析了患者人口统计学、葡萄膜炎类型、单侧性、发病时间、人类白细胞抗原（HLA）类型、眼内压、视力、合并症以及葡萄膜炎和银屑病的治疗和结果的数据。
该队列包括 11 名男性和 9 名女性（发病年龄为 50.1±13.2 岁），平均随访时间为 3.9±4.0 年。葡萄膜炎类型包括前葡萄膜炎（85%）、中间葡萄膜炎（10%）和全葡萄膜炎（5%）。共有 13 例（65%）表现为单侧受累，18 例中有 12 例（66.7%）HLA-B27 阳性。受影响眼的平均眼压在首次就诊时为 11.6±3.6mmHg，在最后一次就诊时为 13.8±3.6mmHg。受影响眼在初始检查时最小分辨角视力对数的平均为 0.16±0.52，在最后一次检查时为 0.27±0.71。最常见的合并症（13 例，65%）是银屑病关节炎（PsA）。所有患者均接受局部皮质类固醇治疗；然而，11 例（55%）需要全身皮质类固醇和免疫抑制剂治疗葡萄膜炎。由于严重的眼内炎症及其并发症（葡萄膜炎性青光眼和大疱性角膜病变），有 2 例（10%）视力明显恶化。57.9%的患者出现葡萄膜炎复发。患有 PsA 的患者 HLA-B27 阳性率较高（83.3%）。然而，葡萄膜炎的位置、是否存在 PsA 以及 HLA-B27 阳性与视力预后之间没有显著相关性。
韩国银屑病患者葡萄膜炎通常表现为单侧前葡萄膜炎。PsA 是最常见的合并症。在大多数患者中，适当的局部或全身免疫抑制治疗可获得满意的视力结果。
