Xue Yan-Qi, Xiao Jin-An, Chen Ying
Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated People's Hospital of Northwest University, No 21, Jiefang Road, Xi'an, 710004, Shaanxi, China.
Ophthalmol Ther. 2023 Oct;12(5):2609-2619. doi: 10.1007/s40123-023-00763-4. Epub 2023 Jul 13.
We investigated the frequency of uveitic macular edema (UME) in patients with different types of noninfectious uveitis and present the primary treatment methods for UME at a specialized eye center in Shaanxi Province, China.
We conducted a retrospective, noninterventional, observational survey involving 1946 patients with noninfectious uveitis (2816 eyes). The collected data included sex, age of uveitis onset, age of UME onset, anatomical classification of uveitis, and the treatment administered to UME patients.
Of the 1946 patients with noninfectious uveitis, 929 (47.74%) were male and 1017 (52.26%) were female. The average age of all participants in the study was 42.19 ± 15.34 years, with average age at uveitis onset of 39.50 ± 15.52 years. Among the patients, 1003 (51.54%), 239 (12.28%), 410 (21.07%), and 294 (15.11%) had anterior uveitis, intermediate uveitis, posterior uveitis, and panuveitis, respectively. UME was observed in 134 (6.89%) of the uveitis patients. The average age of UME patients was 47.33 ± 17.17 years, with average age at uveitis onset of 45.78 ± 17.20 years. Out of the 134 UME patients, 3 (0.30%), 15 (6.28%), 47 (11.46%), and 69 (23.47%) had anterior uveitis, intermediate uveitis, posterior uveitis, and panuveitis, respectively. Among them, 37 were lost to follow-up, 44 received adalimumab (ADA) combined with low-dose prednisone and with or without conventional immunosuppressants, 19 received interferon-α2a therapy, 14 received intravitreal corticosteroid injections (such as dexamethasone implant or fluocinolone acetonide), 11 received low-dose corticosteroids combined with conventional immunosuppressants, 5 received only oral prednisone, and 4 received repeated peribulbar or subconjunctival injections of triamcinolone acetonide.
At our tertiary ophthalmic center in Shaanxi Province, China, only 6.89% of patients with noninfectious uveitis were diagnosed with UME. The primary treatment modality for UME in our center is ADA, in accordance with treatment guidelines and the Chinese medical insurance reimbursement system.
我们调查了不同类型非感染性葡萄膜炎患者中葡萄膜炎性黄斑水肿(UME)的发生率,并介绍了中国陕西省一家专业眼科中心治疗UME的主要方法。
我们进行了一项回顾性、非干预性观察性调查,涉及1946例非感染性葡萄膜炎患者(2816只眼)。收集的数据包括性别、葡萄膜炎发病年龄、UME发病年龄、葡萄膜炎的解剖学分类以及UME患者接受的治疗。
在1946例非感染性葡萄膜炎患者中,男性929例(47.74%),女性1017例(52.26%)。研究中所有参与者的平均年龄为42.19±15.34岁,葡萄膜炎发病的平均年龄为39.50±15.52岁。其中,前葡萄膜炎、中间葡萄膜炎、后葡萄膜炎和全葡萄膜炎患者分别有1003例(51.54%)、239例(12.28%)、410例(21.07%)和294例(15.11%)。134例(6.89%)葡萄膜炎患者出现了UME。UME患者的平均年龄为47.33±17.17岁,葡萄膜炎发病的平均年龄为45.78±17.20岁。在134例UME患者中,前葡萄膜炎、中间葡萄膜炎、后葡萄膜炎和全葡萄膜炎患者分别有3例(0.30%)、15例(6.28%)、47例(11.46%)和69例(23.47%)。其中,37例失访,44例接受阿达木单抗(ADA)联合低剂量泼尼松治疗,同时或不同时使用传统免疫抑制剂,19例接受干扰素-α2a治疗,14例接受玻璃体内注射皮质类固醇(如地塞米松植入剂或曲安奈德),11例接受低剂量皮质类固醇联合传统免疫抑制剂治疗,5例仅接受口服泼尼松治疗,4例接受反复球周或结膜下注射曲安奈德。
在我国陕西省的三级眼科中心,只有6.89%的非感染性葡萄膜炎患者被诊断为UME。根据治疗指南和中国医疗保险报销制度,我们中心治疗UME的主要方式是ADA。