Annamalai Radha, Mahesh Abhinav, Biswas Jyotirmay
Department of Ophthalmology and Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Department of Ophthalmology, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Oman J Ophthalmol. 2023 Oct 18;16(3):472-477. doi: 10.4103/ojo.ojo_250_22. eCollection 2023 Sep-Dec.
The aim of this study was to identify the incidence, etiology, most common presentations, complications, and the causes of visual loss in posterior uveitis (PU).
A retrospective study was conducted on a cohort of 125 patients with PU with a minimum follow-up of 6 months. Ocular evaluation consisted of slit-lamp examination, indirect ophthalmoscopy, tonometry, and refraction. Ancillary ophthalmic investigations such as fundus fluorescein angiography, optical coherence tomography, and B-scan ultrasonography were done. Laboratory tests were performed on blood on all patients and in aqueous humor samples obtained by anterior chamber paracentesis in cases of diagnostic dilemmas. All the data were analyzed using SPSS program.
PU occurred in 61%. Infections were noted in 34% and autoimmune diseases in 27%. The most frequent presentation was choroiditis. The most common etiologies were tubercular uveitis in 50%, retinochoroiditis in 23%, and autoimmune category of serpiginous choroiditis in 56% of patients. Complications occurred in 27% and were most commonly cystoid macular edema and macular scarring. Polymerase chain reaction (PCR), nested PCR, and real-time PCR on ocular fluids were required for diagnosis in 30%. A combination of laboratory investigations on blood and aqueous humor samples were confirmation in 88%.
PU and its sequelae are known to be sight threatening and are associated with systemic diseases. They have diverse etiologies and presentations. Identification of etiology is important as management is diametrically opposite in infections and autoimmune diseases.
本研究旨在确定后葡萄膜炎(PU)的发病率、病因、最常见表现、并发症以及视力丧失的原因。
对125例PU患者进行回顾性研究,随访时间至少6个月。眼部评估包括裂隙灯检查、间接检眼镜检查、眼压测量和验光。进行了眼底荧光血管造影、光学相干断层扫描和B超超声检查等辅助眼科检查。对所有患者进行血液实验室检查,在诊断困难的情况下,对通过前房穿刺获得的房水样本进行检查。所有数据使用SPSS程序进行分析。
PU的发生率为61%。感染占34%,自身免疫性疾病占27%。最常见的表现是脉络膜炎。最常见的病因是结核性葡萄膜炎占50%,视网膜脉络膜炎占23%,自身免疫性匐行性脉络膜炎在56%的患者中出现。27%的患者出现并发症,最常见的是黄斑囊样水肿和黄斑瘢痕形成。30%的患者需要对眼液进行聚合酶链反应(PCR)、巢式PCR和实时PCR以进行诊断。血液和房水样本的实验室检查相结合,确诊率为88%。
已知PU及其后遗症会威胁视力,并与全身性疾病有关。它们有多种病因和表现。由于感染和自身免疫性疾病的治疗方法截然不同,因此确定病因很重要。