Younus Raheel, Saeed Muhammad A, Arshad Muhammad, Farman Sumaira, Ahmad Nighat M
Rheumatology, National Hospital and Medical Centre, Lahore, PAK.
Rheumatology, Central Park Medical College, Lahore, PAK.
Cureus. 2023 Jun 5;15(6):e39965. doi: 10.7759/cureus.39965. eCollection 2023 Jun.
The present study aimed to determine the pattern and cause of noninfectious uveitis in rheumatology practice. The secondary objective was to identify the pattern of treatment and outcomes.
This retrospective cross-sectional study was conducted in the Department of Rheumatology, National Hospital and Medical Centre, Lahore, Pakistan. After receiving consent, electronic medical records (EMRs) of all patients with a diagnosis of noninfectious uveitis (NIU) from November 2019 to January 2023 were reviewed, and a total of 52 patients labeled as having noninfectious uveitis were identified. The collected data included age at diagnosis, anatomical location of uveitis, associated systemic disease, used medications, and outcomes. All cases had been diagnosed and assessed mutually by a rheumatologist and an ophthalmologist using the International Uveitis Study Group classification system to classify the pattern of uveitis by location, clinical course, and laterality and rule out the possibility of other ophthalmologic diseases. Disease activity was defined using the Standardization of Uveitis Nomenclature (SUN) guidelines. Data was analyzed on SPSS Statistics version 23 (IBM Corp, Armonk, NY, USA).
The mean age of the patients in this study was 36.02 ± 43.31 years, with 31 (59.6%) male patients. Anterior uveitis was the most common type observed among the patients at 55.8%, panuveitis was found in 25%, intermediate uveitis and posterior uveitis were seen in 9.6% each. Based on laterality, unilateral eye involvement was identified in 53.8% of patients. Spondyloarthritis (SpA) and idiopathic uveitis were observed in 34.6% and 28.8%, respectively. In this study, 28 (54.9%) patients were on conventional disease-modifying antirheumatic drugs (cDMARDDs), and 23 (45.1%) were on biological DMARDs. In the biologics group, 82% of patients were in remission in comparison to 60% in the cDMARDs group.
To the best of our knowledge, this is the first report on noninfectious uveitis in the Pakistani population. The study concluded that anterior uveitis is the most common type of uveitis and is more common in males. Spondyloarthropathy is one of the most common underlying systemic diseases. Human leukocyte antigen (HLA)-B27 is associated more with uveitis. Biologics are more effective than cDMARDs in controlling the disease. Collaborative work between different specialties resulted in early diagnosis of underlying systemic disease, better management plans, and disease outcomes. To obtain further details on noninfectious uveitis, a population-based study is needed in Pakistan.
本研究旨在确定风湿病实践中非感染性葡萄膜炎的模式和病因。次要目的是确定治疗模式和结果。
本回顾性横断面研究在巴基斯坦拉合尔国家医院和医疗中心的风湿病科进行。获得同意后，对2019年11月至2023年1月所有诊断为非感染性葡萄膜炎（NIU）患者的电子病历（EMR）进行了回顾，共识别出52例标记为患有非感染性葡萄膜炎的患者。收集的数据包括诊断时的年龄、葡萄膜炎的解剖位置、相关的全身性疾病、使用的药物和结果。所有病例均由风湿病学家和眼科医生共同诊断和评估，使用国际葡萄膜炎研究组分类系统根据位置、临床病程和双眼性对葡萄膜炎模式进行分类，并排除其他眼科疾病的可能性。使用葡萄膜炎命名标准化（SUN）指南定义疾病活动度。数据在SPSS Statistics 23版（美国纽约州阿蒙克市IBM公司）上进行分析。
本研究中患者的平均年龄为36.02±43.31岁，男性患者31例（59.6%）。前葡萄膜炎是患者中最常见的类型，占55.8%，全葡萄膜炎占25%，中间葡萄膜炎和后葡萄膜炎各占9.6%。根据双眼性，53.8%的患者为单眼受累。分别观察到脊柱关节炎（SpA）和特发性葡萄膜炎的比例为34.6%和28.8%。在本研究中，28例（54.9%）患者使用传统改善病情抗风湿药物（cDMARDDs），23例（45.1%）患者使用生物性DMARDs。在生物制剂组中，82%的患者病情缓解，而cDMARDs组为60%。
据我们所知，这是关于巴基斯坦人群中非感染性葡萄膜炎的首份报告。该研究得出结论，前葡萄膜炎是最常见的葡萄膜炎类型，在男性中更常见。脊柱关节病是最常见的潜在全身性疾病之一。人类白细胞抗原（HLA）-B27与葡萄膜炎的关联更为密切。生物制剂在控制疾病方面比cDMARDs更有效。不同专业之间的协作工作实现了潜在全身性疾病的早期诊断、更好的管理计划和疾病结果。为了获得关于非感染性葡萄膜炎的更多详细信息，巴基斯坦需要进行基于人群的研究。
