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在日本一家三级医疗机构中,初诊时常见前葡萄膜炎的流行病学和特征。

Epidemiology and characteristics of common forms of anterior uveitis at initial presentation in a tertiary facility in Japan.

机构信息

Department of Ophthalmology, National Defense Medical College, 3-2 Namiki, 359-8513, Tokorozawa, Saitama, Japan.

Sakura street Takayama Eye Clinic, 4-262-1 Sakuragaoka, Higashiyamato, Japan.

出版信息

Jpn J Ophthalmol. 2023 Jan;67(1):22-31. doi: 10.1007/s10384-022-00961-w. Epub 2022 Nov 8.

Abstract

PURPOSE

To elucidate detailed epidemiological profile of common types of anterior uveitis (AU) in real-world clinical setting of a tertiary facility in Japan, and to evaluate the characteristic clinical findings at initial presentation.

STUDY DESIGN

Retrospective cohort study.

METHODS

Clinical charts of 275 patients (335 eyes) aged 52.5 ± 19.1 years were reviewed retrospectively. Herpetic AU was diagnosed by multiplex polymerase chain reaction tests using aqueous humor. Time of uveitis onset, gender, laterality, disease course since the initial onset of AU, visual acuity (VA) and intraocular pressure (IOP) at first visit, and definitive diagnosis were collected from clinical charts.

RESULTS

Acute AU (AAU) was the most common (21.8%) form of AU; followed by herpetic AU (20.7%) comprising Herpes Simplex Virus (HSV) (8.0%), Varicella Zoster Virus (VZV) (9.1%) and cytomegalo virus (CMV) (3.6%); scleritis (13.5%); diabetic iritis (7.6%), and Posner-Schlossman syndrome (5.5%). Unilateral AU constituted 78.2%, and VA less than 20/30 accounted for 31.2%. Of all the eyes, 16.1% had an IOP higher than 20 mmHg, out of which 37.0% had herpetic AU, followed by scleritis in 25.9%, and Posner-Schlossman syndrome (PSS) in 11.1%. AU patients over 60 years of age were 40.4%, in which 34.2% had herpetic AU, followed by scleritis in 14.4% and AAU in 13.5%. Herpetic AU patients were significantly older and had higher IOP compared with AAU patients.

CONCLUSION

The most frequent AU was AAU, followed by herpetic AU. Herpetic AU patients were older and had higher intraocular pressure than AAU patients, although VA was equally impaired in both groups.

摘要

目的

阐明日本一家三级医疗机构真实临床环境中常见前葡萄膜炎(AU)的详细流行病学特征,并评估初始表现时的特征性临床发现。

研究设计

回顾性队列研究。

方法

回顾性分析 275 名(335 只眼)年龄为 52.5±19.1 岁的患者的临床病历。采用水性液聚合酶链反应试验诊断疱疹性 AU。从临床病历中收集葡萄膜炎发病时间、性别、侧别、自 AU 初发以来的病程、首次就诊时的视力(VA)和眼压(IOP)以及明确诊断。

结果

急性 AU(AAU)是最常见的 AU 类型(21.8%);其次是疱疹性 AU(20.7%),包括单纯疱疹病毒(HSV)(8.0%)、水痘带状疱疹病毒(VZV)(9.1%)和巨细胞病毒(CMV)(3.6%);巩膜炎(13.5%);糖尿病性虹膜炎(7.6%)和 Posner-Schlossman 综合征(5.5%)。单侧 AU 占 78.2%,VA 低于 20/30 占 31.2%。所有眼中,16.1%的眼压高于 20mmHg,其中 37.0%患有疱疹性 AU,其次是巩膜炎占 25.9%,Posner-Schlossman 综合征(PSS)占 11.1%。60 岁以上的 AU 患者占 40.4%,其中 34.2%患有疱疹性 AU,其次是巩膜炎占 14.4%,AAU 占 13.5%。疱疹性 AU 患者明显比 AAU 患者年龄更大,IOP 更高。

结论

最常见的 AU 是 AAU,其次是疱疹性 AU。疱疹性 AU 患者比 AAU 患者年龄更大,IOP 更高,尽管两组的 VA 均同样受损。

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