Rathinam S R, Rathnam S, Selvaraj S, Dean D, Nozik R A, Namperumalsamy P
Aravind Eye Hospital, Madurai, India.
Am J Ophthalmol. 1997 Jul;124(1):71-9. doi: 10.1016/s0002-9394(14)71646-0.
To define uveitis associated with leptospirosis in a clinical setting.
We present the clinical features of 73 consecutive cases of uveitis linked clinically to an outbreak of systemic leptospirosis in patients with antibodies to Leptospira species who were examined from January to September 1994.
In 73 patients, the pattern of ocular involvement was unilateral in 35 and bilateral in 38. Panuveitis was seen in 106 eyes (95.5%), retinal periphlebitis in 57 eyes (51.4%), and hypopyon in 14 eyes (12.6%). Anterior uveitis alone without hypopyon was observed in three eyes (2.7%), whereas vitreous inflammatory reaction alone was seen in two eyes (1.8%). Sixty of 73 patients (82.2%) or 91 of 111 eyes (82.0%) were followed up for 8 months. Final visual acuity was 6/6 (20/20) in 47 eyes (52%) and improved during treatment, although not up to 6/6, in 15 eyes (16%). Twenty-eight eyes (31%) maintained same vision, and one eye showed deterioration of vision.
Uveitis associated with leptospirosis may manifest as unilateral or bilateral uveitis, anterior uveitis, or panuveitis. The prognosis is generally good in this entity, even when the inflammation is severe. Awareness of this disease in endemic areas is important in order to differentiate it from other uveitic entities, especially in young male patients in whom other immunologic uveitides are also common.
在临床环境中定义与钩端螺旋体病相关的葡萄膜炎。
我们呈现了1994年1月至9月期间对73例临床上与系统性钩端螺旋体病暴发相关的葡萄膜炎患者的临床特征，这些患者均有针对钩端螺旋体属的抗体。
73例患者中，眼部受累模式为单侧35例，双侧38例。106只眼（95.5%）出现全葡萄膜炎，57只眼（51.4%）出现视网膜周边静脉炎，14只眼（12.6%）出现前房积脓。仅3只眼（2.7%）观察到无前房积脓的单纯前葡萄膜炎，而仅2只眼（1.8%）出现单纯玻璃体炎症反应。73例患者中的60例（82.2%）或111只眼中的91只眼（82.0%）随访了8个月。最终视力在47只眼（52%）中为6/6（20/20），15只眼（16%）在治疗期间视力改善但未达到6/6。28只眼（31%）视力维持不变，1只眼视力下降。
与钩端螺旋体病相关的葡萄膜炎可表现为单侧或双侧葡萄膜炎、前葡萄膜炎或全葡萄膜炎。即使炎症严重，该疾病的预后总体良好。在流行地区认识这种疾病对于将其与其他葡萄膜炎实体区分开来很重要，尤其是在其他免疫性葡萄膜炎也常见的年轻男性患者中。
