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英国葡萄膜炎的变化趋势:向一家三级转诊中心转诊的 5000 例连续病例。

Changing Trends in Uveitis in the United Kingdom: 5000 Consecutive Referrals to a Tertiary Referral Centre.

机构信息

School of Biological Sciences, The University of Manchester, UK.

Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK.

出版信息

Ocul Immunol Inflamm. 2023 Jul;31(5):921-926. doi: 10.1080/09273948.2022.2067067. Epub 2022 Apr 20.

Abstract

PURPOSE

To demonstrate changes in the demography and diagnosis of uveitis in a specialist clinic in the United Kingdom.

METHODS

Retrieval of data including all new referrals to Manchester Uveitis Clinic from 1991 to 2020. The incidence and proportions of diagnoses between 4 quartiles was compared.

RESULTS

5000 patients with uveitis were seen. Referral rates trebled over time. Highly significant increases in referrals were seen for multiple evanescent white dot syndrome-spectrum disorders, syphilis and tuberculosis; increases were also seen for herpetic retinitis, vitreoretinal lymphoma and sarcoidosis. Highly significant decreases were seen for Fuchs' uveitis, Behçet's uveitis and ocular toxoplasmosis.

CONCLUSIONS

Subspecialisation and de-skilling has changed referral patterns to specialist clinics; changes cannot be entirely attributed to disease incidences, which also vary between countries. International data are non-comparable. There are clear changes in referral patterns and disease incidence in this population, influenced by evolving diagnosis. Local data should steer care planning.

摘要

目的

展示英国一家专业诊所中葡萄膜炎患者的人口统计学和诊断变化。

方法

检索包括 1991 年至 2020 年期间所有新转诊至曼彻斯特葡萄膜炎诊所的资料。比较了 4 个四分位数之间的诊断发病率和比例。

结果

共观察了 5000 例葡萄膜炎患者。转诊率随时间呈三倍增长。多发性一过性白点综合征谱疾病、梅毒和结核病的转诊率显著增加;疱疹性视网膜炎、眼内淋巴瘤和结节病的转诊率也有所增加。Fuchs 葡萄膜炎、Behçet 葡萄膜炎和眼弓形体病的转诊率显著下降。

结论

亚专科化和技能下降改变了向专科诊所的转诊模式;这些变化不能完全归因于疾病发病率,而疾病发病率在不同国家之间也有所不同。国际数据不具有可比性。在这一人群中,由于诊断方法的不断发展,转诊模式和疾病发病率均发生了明显变化。当地数据应指导护理计划。

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