Suppr超能文献

结节病性葡萄膜炎临床特征分析

[Analysis on the clinical features of sarcoid uveitis].

作者信息

Yang P Z, Tan H D, Ye Z, Yi S L

机构信息

Department of Ophtalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing 400016, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2023 Mar 11;59(3):196-201. doi: 10.3760/cma.j.cn112142-20220801-00375.

Abstract

To analyze the clinical features of patients with sarcoid uveitis. This was a retrospective case series study. The medical records of 19 086 patients with uveitis admitted to the Department of Ophtalmology, The First Affiliated Hospital of Chongqing Medical University from April 2008 to December 2019 were collected. The general data, medical history, treatment, diagnosis, follow-up, ophthalmic and other auxiliary examinations were retrospectively analyzed. The paired sample Wilcoxon signed rank test was used to compare the best corrected visual acuity (BCVA) of the affected eye at the first visit to the BCVA of the affected eye at the corresponding last visit. A total of 51 patients (97 eyes) with sarcoid uveitis were included, including 15 males (29.4%) and 36 females (70.6%), with a male/female ratio of 1/2.4. There were 46 patients (88 eyes) with presumed sarcoidosis and 5 patients (9 eyes) with definite sarcoidosis. The age of onset was 48 (40, 55) years and 90.2% of patients (46 cases) were involved in both eyes, while 88.2% of the patients (45 cases) were chronic, and only 11.8% (6 cases) showed acute inflammatory response. Anterior uveitis was the most common type (50.5%, 49 eyes). Ophthalmoscopy revealed retinal vasculitis in only 2 eyes (2.1%) and fundus fluorescence angiography (FFA) revealed diffuse vascular leakage of fluorescein in 64 eyes (66.0%). Thirty-one patients (59 eyes) were followed up for≥3 months. Cataract was the most common ocular complication, accounting for 44.1% (26 eyes), and the inflammatory response was controlled in 45 eyes (76.3%) treated with combination of corticosteroids and immunosuppressive agents. The patients were followed up for 21.5 (13.7, 29.3) months. Among 31 patients (59 eyes) followed up for≥3 months, BCVA was≥0.8 in 25 eyes (42.3%) and<0.3 in 15 eyes (25.4%) at the last follow-up, BCVA of 59 affected eyes of 31 patients was better than that at the first visit, the difference was statistically significant (=-2.76, =0.006). Uveitis associated with sarcoidosis or presumed ocular sarcoidosis mainly manifests as a bilateral, chronic anterior uveitis with a subclinical retinal vasculitis. FFA shows subclinical retinal vasculitis in most patients. Glucocorticoid therapy in combination with other immunosuppressive agents can control inflammatory responses and improve visual acuity in most patients.

摘要

分析结节病性葡萄膜炎患者的临床特征。这是一项回顾性病例系列研究。收集了2008年4月至2019年12月在重庆医科大学附属第一医院眼科住院的19086例葡萄膜炎患者的病历。对患者的一般资料、病史、治疗、诊断、随访及眼科和其他辅助检查进行回顾性分析。采用配对样本Wilcoxon符号秩和检验比较患眼首次就诊时的最佳矫正视力(BCVA)与相应末次就诊时患眼的BCVA。共纳入51例(97只眼)结节病性葡萄膜炎患者,其中男性15例(29.4%),女性36例(70.6%),男女比例为1∶2.4。疑似结节病患者46例(88只眼),确诊结节病患者5例(9只眼)。发病年龄为48(40,55)岁,90.2%的患者(46例)双眼受累,88.2%的患者(45例)为慢性,仅11.8%(6例)表现为急性炎症反应。前葡萄膜炎是最常见的类型(50.5%,49只眼)。眼底检查仅2只眼(2.1%)发现视网膜血管炎,眼底荧光血管造影(FFA)显示64只眼(66.0%)有弥漫性荧光素血管渗漏。31例(59只眼)患者随访≥3个月。白内障是最常见的眼部并发症,占44.1%(26只眼),糖皮质激素联合免疫抑制剂治疗的45只眼(76.3%)炎症反应得到控制。患者随访21.5(13.7,29.3)个月。在31例(59只眼)随访≥3个月的患者中,末次随访时25只眼(42.3%)的BCVA≥0.8,15只眼(25.4%)的BCVA<0.3,31例患者59只患眼的BCVA较首次就诊时改善,差异有统计学意义(Z=-2.76,P=0.006)。结节病或疑似眼部结节病相关的葡萄膜炎主要表现为双侧慢性前葡萄膜炎伴亚临床视网膜血管炎。大多数患者FFA显示亚临床视网膜血管炎。糖皮质激素联合其他免疫抑制剂治疗可控制炎症反应,使大多数患者视力提高。

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验