Department of Rheumatology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Department of Ophthalmology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
ScientificWorldJournal. 2022 Feb 8;2022:5032881. doi: 10.1155/2022/5032881. eCollection 2022.
There is a scarcity of information available on clinical and laboratory features of adult-onset idiopathic autoimmune uveitis. Therefore, we conducted a single centre descriptive cross-sectional study. . A chart review of all patients with idiopathic autoimmune uveitis with onset after 18 years of age who were referred to the rheumatology department between January 2017 and December 2018 was performed. Their clinical features, demographic features, and HLA-B genotypes were documented and described.
Out of 210 patients referred to rheumatology, 66 were found to have uveitis, and 16 of these had an adult-onset idiopathic autoimmune uveitis. Apart from a slight female preponderance (62.5%), our patients were characterized by a high proportion of panuveitis (4 out of 16, i.e., 25%). There was an increased frequency of occurrence of synechiae (5 out of 16, i.e., 31.3%), retinal vasculitis (4 out of 16, i.e., 25%), optic disc edema (3 out of 16, i.e., 18.8%), and cystoid macular edema (seen in 2 patients, i.e., 12.5%). These features correlated with the anatomical subtypes. Retinal vasculitis and optic disc edema present in three fourth of all panuveitis cases were the most prominent features. The odds of finding HLA-B∗35 in retinal vasculitis were 33 times higher than odds of finding it in idiopathic autoimmune uveitis patients not having retinal vasculitis (OR 33; 95% CI 1.6-698).
Idiopathic autoimmune uveitis in our patients is characterized by a high frequency of panuveitis and retinal vasculitis, and complications with a probable association between HLA-B∗35 and retinal vasculitis.
成人特发性自身免疫性葡萄膜炎的临床和实验室特征的相关信息较为匮乏。因此，我们开展了一项单中心描述性横断面研究。我们对 2017 年 1 月至 2018 年 12 月期间转诊至风湿病科的所有 18 岁以后发病的特发性自身免疫性葡萄膜炎患者进行了病历回顾。记录并描述了他们的临床特征、人口统计学特征和 HLA-B 基因型。
在转诊至风湿病科的 210 名患者中，发现有 66 名患者患有葡萄膜炎，其中 16 名患者为特发性自身免疫性葡萄膜炎。除了略多的女性（62.5%），我们的患者中还存在较高比例的全葡萄膜炎（16 例患者中有 4 例，即 25%）。出现虹膜后粘连（16 例患者中有 5 例，即 31.3%）、视网膜血管炎（16 例患者中有 4 例，即 25%）、视盘水肿（16 例患者中有 3 例，即 18.8%）和黄斑囊样水肿（2 例患者，即 12.5%）的患者比例较高。这些特征与解剖亚型相关。所有全葡萄膜炎病例中，有四分之三出现了视网膜血管炎和视盘水肿，这是最显著的特征。出现视网膜血管炎的患者中 HLA-B*35 的检出率比未出现视网膜血管炎的特发性自身免疫性葡萄膜炎患者高 33 倍（OR 33；95%CI 1.6-698）。
我们的患者中特发性自身免疫性葡萄膜炎的特征是全葡萄膜炎和视网膜血管炎的发生率较高，且并发症可能与 HLA-B*35 有关。
