Visual manifestations in giant cell arteritis: trend over 5 decades in a population-based cohort.
Visual manifestations in giant cell arteritis: trend over 5 decades in a population-based cohort.
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DOI：
10.3899/jrheum.140188
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发表时间：
2015-02
期刊：
影响因子：
--
通讯作者：
Warrington KJ
中科院分区：
文献类型：
--
作者：
Singh AG;Kermani TA;Crowson CS;Weyand CM;Matteson EL;Warrington KJ
评估巨细胞动脉炎 (GCA) 导致视力改变的患者的临床特征、治疗和结果，并检查过去 5 年来的趋势。我们回顾了 1950 年至 2004 年间诊断的以人群为基础的 GCA 患者队列的医疗记录。将具有 GCA 视觉表现的患者与没有视觉并发症的患者的临床、眼科和实验室特征进行了比较。使用针对年龄和性别进行调整的逻辑回归模型来检查随时间变化的趋势。在 204 名 GCA 病例（平均年龄 76.0 ± 8.2 岁，80% 女性）的队列中，47 名患者 (23%) 观察到 GCA 引起的视力变化，4.4% 的患者视力完全丧失。与没有视力变化的患者相比，有视觉表现的患者出现下颌跛行的比例更高（55% vs 38%，p=0.04）。 55 年来，我们观察到 GCA 引起的视觉症状发生率显着下降。与 1950-1979 年相比，1980-2004 年队列中缺血性视神经病变的发生率较低（6% vs 15%，p=0.03）。晚几十年诊断的患者更有可能从视觉症状中恢复（HR，95% CI：1.34（1.06-1.71）。前部缺血性视神经病变或视力完全丧失的患者恢复的机会很差。过去 5 年来，视觉症状的发生率有所下降，视觉症状恢复的机会有所提高。然而，视力完全丧失基本上是不可逆的。下颌跛行与出现视觉症状的可能性较高有关。
To evaluate clinical characteristics, treatment and outcomes of patients with visual changes from giant cell arteritis (GCA) and, to examine trends over the last 5 decades. We reviewed the medical records of a population-based cohort of GCA patients diagnosed between 1950 and 2004. The clinical, ophthalmological and laboratory features of patients with visual manifestations attributable to GCA were compared to patients without visual complications. Trends over time were examined using logistic regression modeling adjusted for age and sex. In a cohort of 204 cases of GCA (mean age 76.0 ± 8.2 years, 80% female), visual changes from GCA were observed in 47 patients (23%), 4.4% suffered complete vision loss. A higher proportion of patients with visual manifestations reported jaw claudication than patients without visual changes (55% versus 38%, p=0.04). Over a period of 55 years, we observed a significant decline in the incidence of visual symptoms due to GCA. There was a lower incidence of ischemic optic neuropathy in the 1980–2004 cohort vs 1950–1979 (6% vs 15%, p=0.03). Patients diagnosed in later decades were more likely to recover from visual symptoms (HR, 95% CI: 1.34 (1.06–1.71). Chances of recovery were poor in patients with anterior ischemic optic neuropathy or complete vision loss. Incidence of visual symptoms has declined over the past 5 decades, and chances of recovery from visual symptoms have improved. However, complete loss of vision is essentially irreversible. Jaw claudication is associated with higher likelihood of development of visual symptoms.
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影响因子：
--
作者：
BENGTSSON, BA;MALMVALL, BE
通讯作者：
MALMVALL, BE
影响因子：
4.1
作者：
Chan, CCK;Paine, M;O'Day, J
通讯作者：
O'Day, J
DOI：
10.1001/jama.1957.02970450023007
发表时间：
1957-01-01
影响因子：
120.7
作者：
BIRKHEAD, NC;WAGENER, HP;SHICK, RM
通讯作者：
SHICK, RM
影响因子：
--
作者：
Nuenninghoff, DM;Hunder, GG;Matteson, EL
通讯作者：
Matteson, EL
影响因子：
--
作者：
COOKE, WT;CLOAKE, PCP;COLBECK, JC
通讯作者：
COLBECK, JC