Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", PhD in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, 00133 Rome, Italy.
Department of Clinical Medicine and Surgery, School of Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy.
Int J Mol Sci. 2023 Jun 2;24(11):9690. doi: 10.3390/ijms24119690.
Non-infectious uveitis (NIU) can be an early or even the first extra-articular manifestation of systemic rheumatic diseases, or the first one; thus, rheumatologists are often involved in the diagnostic and therapeutic assessment of NIU. We evaluated 130 patients with a diagnosis of NIU who were admitted to two Italian rheumatologic clinics (Tor Vergata University Hospital in Rome, and Federico II University in Naples) from January 2018 to December 2021. Anterior uveitis (AU) occurred in 75.4% of patients, followed by posterior uveitis (PU, 21.5%); acute (54.6%) and recurrent (35.4%) NIU were more documented than chronic NIU (10%), and a bilateral involvement was observed in 38.7% of cases. Half of NIU cases were associated with spondyloarthritis (SpA); the remaining were affected by Behçet disease (BD)-related uveitis (13.9%) and idiopathic NIU (9.2%). HLA-B27 patients (34.8%) had a higher prevalence of anterior and unilateral NIU ( = 0.005) with acute course ( = 0.04) than HLA-B27 patients. On the contrary, HLA-B51 patients (19.6%) had mostly PU and bilateral NIU ( < 0.0001) and recurrent course ( = 0.04) than HLA-B51 patients. At the first rheumatologic referral, 117 patients (90%) received systemic treatments. Findings from this study demonstrate that rheumatologic referral has a pivotal role in the diagnostic work-up of NIU and may dramatically influence NIU-treatment strategies.
非感染性葡萄膜炎（NIU）可作为全身风湿性疾病的早期表现，甚至是首发表现，或为首发表现；因此，风湿病学家通常参与 NIU 的诊断和治疗评估。我们评估了 2018 年 1 月至 2021 年 12 月期间，在意大利两家风湿科诊所（罗马 Tor Vergata 大学医院和那不勒斯 Federico II 大学）就诊的 130 例 NIU 患者。75.4%的患者发生前葡萄膜炎（AU），21.5%发生后葡萄膜炎（PU）；急性（54.6%）和复发性（35.4%）NIU 比慢性 NIU（10%）更常见，38.7%的病例为双侧受累。一半的 NIU 病例与脊柱关节炎（SpA）有关；其余病例分别由与 Behçet 病（BD）相关的葡萄膜炎（13.9%）和特发性 NIU（9.2%）引起。HLA-B27 阳性患者（34.8%）更易出现单侧、前葡萄膜炎（ = 0.005）和急性病程（ = 0.04），而 HLA-B27 阴性患者则更易出现双侧、后葡萄膜炎（ < 0.0001）和复发性病程（ = 0.04）。在首次风湿科就诊时，117 例（90%）患者接受了全身治疗。本研究结果表明，风湿科就诊在 NIU 的诊断评估中具有关键作用，可能会显著影响 NIU 的治疗策略。
