Mohapatra Ayushi, Sudharshan Sridharan, Majumder Parthopratim Dutta, Sreenivasan Janani, Raman Rajiv
Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Department of Uvea, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Ophthalmol Sci. 2024 Mar 7;4(6):100511. doi: 10.1016/j.xops.2024.100511. eCollection 2024 Nov-Dec.
To describe the clinical profile and complications of diabetic retinopathy (DR) and uveitis in patients with coexisting conditions and to derive associations based on site of primary inflammation, stage of DR, and complications of each.
Single-center, cross-sectional observational study.
Sixty-six patients with coexisting DR and uveitis.
Electronic medical records of 66 such cases were evaluated. The demographic data, diabetic status, clinical characteristics, and complications of DR and uveitis on the final follow-up were recorded.
Associations between best corrected visual acuity (BCVA), prevalence of various stages, and complications of DR among eyes with and without uveitis, and correlation between the intensity and primary sites of inflammation among eyes with proliferative and nonproliferative changes.
Of the 132 eyes, all had DR and 97 eyes had uveitis (35 unilateral and 31 bilateral cases). Mean age of patients was 53.4 ± 8.7 years, duration of diabetes was 10.5 ± 6.9 years, and duration of uveitis was 61.3 ± 68.8 months. Of uveitis patients, 54.6% had anterior uveitis (AU), 20.6% had intermediate, 10.3% posterior, and 14.4% panuveitis. Forty-nine point five percent of eyes had proliferative DR (PDR) changes. There was a higher proportion PDR cases among anterior (56.6%), posterior (70%), and panuveitis (64.3%), with difference in AU cases approaching statistical significance ( = 0.067). Conversely, significant ( < 0.001) intermediate uveitis cases had nonproliferative changes (80%). Final BCVA was significantly poorer in the group with uveitis ( = 0.045). The proportion of fibrovascular proliferations, tractional detachments. and iris neovascularization among proliferative retinopathy eyes with uveitis (14.6%, 18.8%, and 12.5% respectively) was higher than those without uveitis (5.3%, 10.5%, and 5.3%). Among uveitis cases, 58.5% eyes developed cataracts, 44.3% had posterior synechiae, 12.3% developed secondary glaucoma, 4.1% had epiretinal membrane, 4.1% had band-shaped keratopathy, and 1.0% developed macular neovascularization.
Eyes with coexisting DR and uveitis have a higher prevalence of neovascular and uveitis complications along with a risk of poorer visual outcomes. Treatment should aim at limiting the duration and intensity of inflammation. Strict glycemic control is essential for inflammation control and preventing the progression of DR to more advanced stages.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
描述合并其他病症的糖尿病视网膜病变（DR）和葡萄膜炎患者的临床特征及并发症，并根据原发性炎症部位、DR分期及各自并发症得出相关性。
单中心横断面观察性研究。
66例合并DR和葡萄膜炎的患者。
评估66例此类病例的电子病历。记录人口统计学数据、糖尿病状况、临床特征以及末次随访时DR和葡萄膜炎的并发症。
有葡萄膜炎和无葡萄膜炎的眼睛之间最佳矫正视力（BCVA）、各阶段患病率及DR并发症之间的相关性，以及有增殖性和非增殖性改变的眼睛炎症强度与原发性部位之间的相关性。
在132只眼中，均患有DR，97只眼患有葡萄膜炎（35例单侧和31例双侧病例）。患者平均年龄为53.4±8.7岁，糖尿病病程为10.5±6.9年，葡萄膜炎病程为61.3±68.8个月。葡萄膜炎患者中，54.6%患有前葡萄膜炎（AU），20.6%患有中间葡萄膜炎，10.3%患有后葡萄膜炎，14.4%患有全葡萄膜炎。49.5%的眼睛有增殖性DR（PDR）改变。前葡萄膜炎（56.6%）、后葡萄膜炎（70%）和全葡萄膜炎（64.3%）中PDR病例比例较高，AU病例差异接近统计学意义（P = 0.067）。相反，中间葡萄膜炎病例有显著差异（P < 0.001），为非增殖性改变（80%）。葡萄膜炎组最终BCVA明显较差（P = 0.045）。有葡萄膜炎的增殖性视网膜病变眼中纤维血管增殖、牵拉性视网膜脱离和虹膜新生血管形成的比例（分别为14.6%、18.8%和12.5%）高于无葡萄膜炎的眼（分别为5.3%、10.
