Yoneda Yu, Usui Yoshihiko, Tanaka Rie, Hase Keitaro, Namba Kenichi, Kamoi Koju, Takase Hiroshi, Takeuchi Masaki, Matsumiya Wataru, Kusuhara Sentaro, Takeda Atsunobu, Yawata Nobuyo, Yanai Ryoji, Hiyama Tomona, Harada Yosuke, Hashida Noriyasu, Maruyama Kazuichi, Nakai Kei, Taguchi Ryo, Kaburaki Toshikatsu, Mizuki Nobuhisa, Goto Hiroshi, Fujino Yujiro, Takeuchi Masaru
Department of Ophthalmology, National Defense Medical College, Tokorozawa, Japan.
Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan.
Front Med (Lausanne). 2022 Sep 30;9:999804. doi: 10.3389/fmed.2022.999804. eCollection 2022.
To investigate the causes of low prevalence of Fuchs' uveitis syndrome (FUS) in Japan.
Medical records of 160 patients diagnosed with FUS at 14 uveitis specialty facilities in Japan were reviewed retrospectively.
In 160 FUS patients, mean follow-up period before referral to our uveitis facilities was 31.6 ± 50.9 months. The most common reason for referral was idiopathic uveitis (61.9%), followed by cataract (25.0%), high intraocular pressure (IOP) including glaucoma (16.3%), and FUS (14.4%). Unilateral involvement was 96.9%. The most frequent ocular finding of FUS was anterior inflammation (91.9%), followed by stellate-shaped keratic precipitates (88.1%), cataract/pseudophakia (88.1%), diffuse iris atrophy (84.4%), vitreous opacity (62.5%), heterochromia (53.1%) and high IOP including glaucoma (36.3%). As treatments of these ocular findings, cataract surgery was performed in 52.5%, glaucoma surgery in 10.6%, and vitrectomy in 13.8%. Mean logMAR VA was 0.28 ± 0.59 at the initial visit, and decreased significantly to 0.04 ± 0.32 at the last visit. Proportions of FUS patients with BCVA <0.1 and 0.1 to <0.5 decreased, while that of ≥0.5 increased at the last visit compared with the initial visit.
Ocular findings of FUS in Japanese FUS patients were consistent with the characteristic features. The low prevalence of FUS in Japan may be a result of being overlooked and misdiagnosed as mild idiopathic uveitis, cataract, and/or glaucoma.
探讨日本富克斯葡萄膜炎综合征(FUS)患病率低的原因。
回顾性分析日本14家葡萄膜炎专科机构诊断为FUS的160例患者的病历。
160例FUS患者转诊至我们葡萄膜炎机构前的平均随访期为31.6±50.9个月。转诊的最常见原因是特发性葡萄膜炎(61.9%),其次是白内障(25.0%)、包括青光眼在内的高眼压(16.3%)和FUS(14.4%)。单侧受累占96.9%。FUS最常见的眼部表现是前部炎症(91.9%),其次是星状角膜后沉着物(88.1%)、白内障/人工晶状体眼(88.1%)、弥漫性虹膜萎缩(84.4%)、玻璃体混浊(62.5%)、异色症(53.1%)和包括青光眼在内的高眼压(36.3%)。针对这些眼部表现,52.5%的患者接受了白内障手术,10.6%的患者接受了青光眼手术,13.8%的患者接受了玻璃体切除术。初诊时平均logMAR视力为0.28±0.59,末次随访时显著降至0.04±0.32。与初诊相比,末次随访时最佳矫正视力(BCVA)<0.1和0.1至<0.5的FUS患者比例下降,而≥0.5的患者比例增加。
日本FUS患者的眼部表现与特征相符。日本FUS患病率低可能是由于被忽视以及被误诊为轻度特发性葡萄膜炎、白内障和/或青光眼。