Sharma Gunjan, Arora Atul, Rojas-Carabali William, Lee Bernett, Gupta Amod, Bansal Reema, Dogra Mohit, Katoch Deeksha, Sharma Aman, Jindal Ankur, Suri Deepti, Singh Surjit, Agrawal Rupesh, Gupta Vishali
Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Eye (Lond). 2025 Apr 5. doi: 10.1038/s41433-025-03772-8.
To analyse the evolution of uveitis diagnosis over a 10-year period, emphasizing the change in etiological diagnosis, and the factors associated with recurrences.
Retrospective chart review.
A total of 15,000 patients with uveitis presented at our tertiary care institute in North India between 1992 and 2023. Of these,123 patients completed 10-year follow-up and were included in the study. The data of patients was collected on an offline purpose-built uveitis registry portal: Ocular Autoimmune Systemic Inflammatory and Infectious Study(OASIS).
The study included 123 patients (48.78% males; mean age: 29.11 ± 15.22 years). The most common anatomical and etiological diagnosis at presentation were anterior (49/123,34.96%) and idiopathic(59/123,47.97%) uveitis respectively. At the end of 10 years, anterior uveitis remained the most common anatomical diagnosis (43/123,39.83%) while the most common etiological diagnosis was immune-mediated uveitis (50/123,40.65%). An etiological diagnosis could be established in 50.85% (30/59) of patients initially labelled as idiopathic. Tuberculous uveitis (39/44, 88.63%) and Juvenile Idiopathic Arthritis associated uveitis (16/49, 32.65%) were the commonest infectious and immune-mediated aetiologies at the 10-year follow-up. Ninety-six (80.67%) patients experienced multiple episodes of ocular inflammation with a mean recurrence rate of 0.386 ± 0.24 recurrences/year. Anterior uveitis (p = 0.01), the change in etiological diagnosis after the first year (p = 0.03), positive HLA-B27 at baseline (p = 0.04), and the diagnosis of a systemic disease prior to the onset of uveitis were associated with higher recurrences rates (p = 0.03).
Over 10-year of follow-up, half of the uveitis diagnoses evolved from idiopathic to specific infectious or immune-mediated aetiologies. Our results indicate that patients with a high recurrence rate may benefit from re-evaluation to find the definitive cause of uveitis.
分析10年间葡萄膜炎诊断的演变情况，重点关注病因诊断的变化以及与复发相关的因素。
回顾性病历审查。
1992年至2023年期间，共有15000例葡萄膜炎患者在印度北部的三级医疗机构就诊。其中，123例患者完成了10年的随访并纳入研究。患者数据通过专门构建的离线葡萄膜炎登记门户：眼部自身免疫性全身炎症和感染性研究（OASIS）收集。
该研究纳入了123例患者（男性占48.78%；平均年龄：29.11±15.22岁）。就诊时最常见的解剖学和病因诊断分别为前葡萄膜炎（49/123，34.96%）和特发性葡萄膜炎（59/123，47.97%）。10年末，前葡萄膜炎仍是最常见的解剖学诊断（43/123，39.83%），而最常见的病因诊断是免疫介导性葡萄膜炎（50/123，40.65%）。最初诊断为特发性的患者中，50.85%（30/59）可确定病因。结核性葡萄膜炎（39/44，88.63%）和幼年特发性关节炎相关葡萄膜炎（16/49，32.65%）是10年随访中最常见的感染性和免疫介导性病因。96例（80.67%）患者经历了多次眼部炎症发作，平均复发率为0.386±0.24次/年。前葡萄膜炎（p = 0.01）、第一年病因诊断的变化（p = 0.03）、基线时HLA - B27阳性（p = 0.04）以及葡萄膜炎发作前的全身性疾病诊断与较高的复发率相关（p = 0.03）。
经过10年的随访，一半的葡萄膜炎诊断从特发性演变为特定的感染性或免疫介导性病因。我们的结果表明，复发率高的患者可能受益于重新评估以找到葡萄膜炎的确切病因。
