Kudsi Maysoun, Al-Darwish Lama, Khalayli Naram, Abouharb Dani, Abouharb Lana, Almajzoub Rahaf, Deeb Haya
Faculty of Medicine, Damascus University.
Faculty of Pharmacy, Al-Sham Private University, Damascus, Syria.
Ann Med Surg (Lond). 2024 Apr 19;86(7):3929-3935. doi: 10.1097/MS9.0000000000002054. eCollection 2024 Jul.
Uveitis, a notable cause of severe visual impairment, is frequently characterized as infectious or noninfectious autoimmune uveitis (AU), the latter of which is commonly associated with younger individuals and systemic diseases. Despite the condition's widespread impact, there are substantial gaps in the comprehension of its pathogenesis, clinical presentation, and therapeutic response, particularly concerning systemic disease-associated uveitis.
The current study aims to bridge these gaps through an extensive examination of demographic and clinical features in AU patients, thereby informing future research, and therapeutic strategies, and improving patient outcomes.
This retrospective observational study analyzed 261 patients with systemic disease-associated uveitis from January 2018 to December 2022 in Damascus, Syria. With diagnoses made using the Standardization of Uveitis Nomenclature Working Group Criteria, the study evaluated tailored treatment efficacy at the 24-month post-treatment mark, alongside comprehensive ophthalmic examinations, laboratory evaluations, and radiographic assessments.
In our study, included 87 patients with Systemic Disease-Associated Autoimmune Uveitis (SDA-AU). Women represented 64.36% of this group, and the mean age at diagnosis was 39.8±17.9 years (range 7-71) for men and 43.8±15.4 years (range 11-69). The most reported symptom was a painful red eye (52.87%). The onset of symptoms was sudden for 32.18% of patients, while 67.81% reported gradual development. Complications occurred in 33.33% of patients, including cataracts (41.37% of those with complications) and glaucoma (17.24%). Laboratory evaluations showed elevated inflammation markers in 66.66% of patients. Upon the 24-month assessment, 48.27% of patients achieved complete remission, 37.93% showed significant improvement, while disease worsened in 13.79% of cases.
Our findings demonstrated that the presentation of AU in this cohort frequently precedes the diagnosis of systemic diseases, affirming the vital role of an early and accurate diagnosis of uveitis for the detection of underlying systemic conditions. In conclusion, our study underlines the significance of a comprehensive and multidisciplinary approach in the management of SD-AU, leading to improved prognosis and quality of life for patients.
葡萄膜炎是严重视力损害的一个显著原因,常被分为感染性或非感染性自身免疫性葡萄膜炎(AU),后者通常与年轻个体和全身性疾病相关。尽管该疾病影响广泛,但在其发病机制、临床表现和治疗反应的理解上仍存在重大差距,尤其是与全身性疾病相关的葡萄膜炎。
本研究旨在通过对AU患者的人口统计学和临床特征进行广泛检查来弥合这些差距,从而为未来的研究、治疗策略提供信息,并改善患者预后。
这项回顾性观察研究分析了2018年1月至2022年12月在叙利亚大马士革的261例与全身性疾病相关的葡萄膜炎患者。根据葡萄膜炎命名标准化工作组标准进行诊断,该研究在治疗后24个月时评估了定制治疗的疗效,同时进行了全面的眼科检查、实验室评估和影像学评估。
在我们的研究中,纳入了87例与全身性疾病相关的自身免疫性葡萄膜炎(SDA-AU)患者。该组中女性占64.36%,男性诊断时的平均年龄为39.8±17.9岁(范围7 - 71岁),女性为43.8±15.4岁(范围11 - 69岁)。最常报告的症状是疼痛性眼红(52.87%)。32.18%的患者症状突发,而67.81%的患者报告症状逐渐发展。33.33%的患者出现并发症,包括白内障(并发症患者中的41.37%)和青光眼(17.24%)。实验室评估显示66.66%的患者炎症标志物升高。在24个月评估时,48.27%的患者实现完全缓解,37.93%有显著改善,而13.79%的病例病情恶化。
我们的研究结果表明,该队列中AU的表现常常先于全身性疾病的诊断,证实了葡萄膜炎早期准确诊断对于发现潜在全身性疾病的关键作用。总之,我们的研究强调了在SD-AU管理中采用全面多学科方法的重要性,可改善患者的预后和生活质量。