Simmons C A, Mathews D
Omni Eye Service, Memphis, TN 38117.
J Am Optom Assoc. 1993 Jun;64(6):386-9.
Uveitis is commonly seen in optometric practice, and anterior uveitis accounts for more than 75% of all uveitis. Uveitis may be the initial manifestation of an associated systemic disease process; and, with proper testing and diagnosis, the patient's ocular and systemic condition may be more effectively treated.
Retrospectively, 194 charts from a referral practice with a general diagnosis of uveitis, retinitis, or chorioretinal scar were reviewed to determine medical history, clinical findings, tests performed, and specific diagnoses obtained.
The majority of cases, 87.6%, were anterior uveitis with more than half, 54.7%, presenting with undetermined etiology. Trauma was the cause of the next most common group of anterior uveitis patients, 21.8%, and accounted for 19.1% of all uveitis cases. Glaucomatocyclitic crisis was seen in 8 cases, 4.1%, while there were 7 patients with sarcoid disease, and 5 with ankylosing spondylitis or systemic lupus erythematosus. Posterior uveitis was the principle finding in 12.4% of cases with ocular histoplasmosis being most common. There were 4 cases of toxoplasmosis and 3 cases of pars planitis.
Utilization of laboratory testing proved to be most valuable in the treatment and management of uveitis. Although there were fewer cases of pars planitis reported in our study in comparison to previous reports, the mix of cases of uveitis in our study was comparable to the work of others in the field. Accurate diagnosis of these cases is quite important since the treatment and prognosis for recovery is variable and different with its associated diseases.
葡萄膜炎在验光实践中较为常见,前葡萄膜炎占所有葡萄膜炎病例的75%以上。葡萄膜炎可能是相关全身性疾病过程的初始表现;通过适当的检查和诊断,患者的眼部和全身状况可能会得到更有效的治疗。
回顾性地查阅了194份转诊病历,这些病历的一般诊断为葡萄膜炎、视网膜炎或脉络膜视网膜瘢痕,以确定病史、临床发现、进行的检查以及获得的具体诊断。
大多数病例(87.6%)为前葡萄膜炎,其中一半以上(54.7%)病因不明。外伤是第二常见的前葡萄膜炎病因组,占前葡萄膜炎患者的21.8%,占所有葡萄膜炎病例的19.1%。青光眼睫状体炎危象见于8例(4.1%),结节病患者有7例,强直性脊柱炎或系统性红斑狼疮患者有5例。后葡萄膜炎是12.4%病例的主要发现,眼部组织胞浆菌病最为常见。有4例弓形虫病和3例周边部葡萄膜炎。
实验室检查在葡萄膜炎的治疗和管理中被证明最有价值。尽管与以往报告相比,我们的研究中周边部葡萄膜炎的病例较少,但我们研究中葡萄膜炎病例的构成与该领域其他研究相当。准确诊断这些病例非常重要,因为其治疗和恢复预后因相关疾病而异。