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成人急性非感染性前葡萄膜炎的管理——北美葡萄膜炎专家的实践模式

Management of Acute Non-Infectious Anterior Uveitis in Adults - Practice Patterns Among Uveitis Specialists in North America.

作者信息

Zhang Howard, Nicholson Crystal M, Kempen John H, Ying Gui-Shuang, Gangaputra Sapna S

机构信息

Vanderbilt Eye Institute, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.

Vanderbilt Eye Institute, Sight for Souls, Bellevue, Washington, USA.

出版信息

Ocul Immunol Inflamm. 2024 May 15:1-6. doi: 10.1080/09273948.2024.2346819.

Abstract

PURPOSE

This study aims to understand the practice patterns among ophthalmologists in North America who manage patients with acute, non-infectious anterior uveitis.

METHODS

An eight-question survey was designed to elucidate the practice patterns of ophthalmologists across various geographic locations and practice settings regarding the management of anterior uveitis. This survey was distributed via the American Uveitis Society and Young Uveitis Specialists email listserv to ophthalmologists who self-identify as uveitis specialists and have a patient population that is at least 30% uveitis.

RESULTS

A total of 102 responses were received and analyzed (37% response rate). Respondents practiced predominantly in North America, and 40% had received subspecialty training in uveitis. All respondents chose topical corticosteroid therapy as first-line treatment for acute, unilateral, or bilateral non-infectious idiopathic anterior uveitis. The most common initial frequency for prednisolone acetate administration was six times/day while the patient was awake (29.7%) and patients are typically seen in follow-up within a week (75% of respondents). If there is a lack of treatment response within 2-3 weeks with the initial topical treatment, 42 respondents (41.2%) chose to switch to difluprednate eye drops and 29 (28.4%) recommended switching to oral prednisone.

CONCLUSION

Our results show that topical corticosteroid, most frequently prednisolone acetate 1%, is the treatment of choice for patients with acute noninfectious anterior uveitis. Reported initial medication dosing and follow-up care approaches are highly variable, which suggests heterogeneity in practice patterns. Further research on the optimal initial dosing is needed.

摘要

目的

本研究旨在了解北美眼科医生对急性非感染性前葡萄膜炎患者的治疗模式。

方法

设计了一份包含八个问题的调查问卷,以阐明不同地理位置和执业环境的眼科医生在前葡萄膜炎治疗方面的实践模式。该问卷通过美国葡萄膜炎学会和青年葡萄膜炎专家电子邮件列表发送给自认为是葡萄膜炎专科医生且其患者群体中葡萄膜炎患者至少占30%的眼科医生。

结果

共收到102份回复并进行了分析(回复率为37%)。受访者主要在北美执业,40%接受过葡萄膜炎亚专业培训。所有受访者均选择局部使用皮质类固醇疗法作为急性单侧或双侧非感染性特发性前葡萄膜炎的一线治疗方法。醋酸泼尼松龙给药的最常见初始频率是患者清醒时每天六次(29.7%),且患者通常在一周内接受随访(75%的受访者)。如果初始局部治疗在2 - 3周内缺乏治疗反应,42名受访者(41.2%)选择改用双氟泼尼定滴眼液,29名(28.4%)建议改用口服泼尼松。

结论

我们的结果表明,局部使用皮质类固醇,最常用的是1%醋酸泼尼松龙,是急性非感染性前葡萄膜炎患者的首选治疗方法。报告的初始药物剂量和随访护理方法差异很大,这表明实践模式存在异质性。需要对最佳初始剂量进行进一步研究。

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