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老年特发性葡萄膜炎的临床与研究特征分析:来自印度的首个病例系列。

An Analysis of the clinical and investigative profile of uveitis in the elderly: First case series from India.

机构信息

Department of Optometry, Sankara Nethralaya, 18, College Road, Chennai, Tamil Nadu, India.

Department of Uvea, Medical and Vision Research Foundations, Sankara Nethralaya, 18, College Road, Chennai, Tamil Nadu, India.

出版信息

Indian J Ophthalmol. 2024 Jul 1;72(Suppl 4):S596-S600. doi: 10.4103/IJO.IJO_2788_23. Epub 2024 Mar 8.

Abstract

PURPOSE

To evaluate the spectrum of uveitis occurring after 60 years of age in elderly patients who presented to a tertiary care eye center in India.

METHODS

Retrospective study of patients who visited a tertiary eye care institute between January 2010 and July 2020.

RESULT

Eighty-seven patients developed uveitis after 60 years, with only 44.8% having sufficient follow-up documentation and were included in the final analysis. The median age of these patients was 64 (IQR: 62-70) years, and 69% of them were male. Among the identifiable causes of uveitis, infectious uveitis (36%) was the most common and noninfectious uveitis was noted in 23% of patients. The most common subtype of uveitis was anterior uveitis (52%), followed by intermediate uveitis (32%), panuveitis (11%), and posterior uveitis (7%). Tuberculosis (28%) was the most common cause in our cohort, followed by HLA B27 (10%), sarcoid (8%), and Vogt-Koyanagi-Harada disease (5%). In 41% of patients, a definitive diagnosis of uveitis could not be achieved, and the anterior uveitis group had the highest number of undifferentiated uveitis cases. There were no undifferentiated cases of uveitis in the posterior and panuveitis category. The median follow-up period of these patients was 52 (15-91) months and 66% of eyes had recurrence. A statistically significant improvement in vision was seen in anterior uveitis and panuveitis groups, whereas the median visual acuity of the intermediate uveitis group remained stable throughout the follow-up period.

CONCLUSION

Uveitis in the elderly can have a higher recurrence rate; however, the lack of follow-up in these groups of patients is a major challenge.

摘要

目的

评估在印度一家三级保健眼科中心就诊的老年患者中 60 岁后发生的葡萄膜炎谱。

方法

对 2010 年 1 月至 2020 年 7 月期间在一家三级眼科保健机构就诊的患者进行回顾性研究。

结果

87 例患者 60 岁后发生葡萄膜炎,仅有 44.8%的患者有足够的随访记录并纳入最终分析。这些患者的中位年龄为 64(IQR:62-70)岁,69%为男性。在可识别的葡萄膜炎病因中,感染性葡萄膜炎(36%)最为常见,23%的患者为非感染性葡萄膜炎。最常见的葡萄膜炎亚型为前葡萄膜炎(52%),其次为中间葡萄膜炎(32%)、全葡萄膜炎(11%)和后葡萄膜炎(7%)。在我们的队列中,结核病(28%)是最常见的病因,其次是 HLA B27(10%)、结节病(8%)和 Vogt-Koyanagi-Harada 病(5%)。在 41%的患者中,无法明确诊断为葡萄膜炎,前葡萄膜炎组未分化葡萄膜炎病例最多。后葡萄膜炎和全葡萄膜炎组均无未分化的葡萄膜炎病例。这些患者的中位随访期为 52(15-91)个月,66%的眼复发。前葡萄膜炎和全葡萄膜炎组视力均有显著改善,而中间葡萄膜炎组的中位视力在整个随访期间保持稳定。

结论

老年患者的葡萄膜炎复发率可能较高;然而,这些患者群体的随访不足是一个主要挑战。

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