Clinical features of ocular sarcoidosis: severe, refractory, and prolonged inflammation
Clinical features of ocular sarcoidosis: severe, refractory, and prolonged inflammation
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眼结节病的临床特征：严重、难治性、长期炎症
DOI：
10.1007/s10384-022-00927-y
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发表时间：
2022
影响因子：
2.4
通讯作者：
Ishida Susumu
中科院分区：
文献类型：
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作者：
Suzuki Kayo;Ishihara Mami;Namba Kenichi;Ohno Shigeaki;Goto Hiroshi;Takase Hiroshi;Kawano Shigeru;Shibuya Etsuko;Hase Keitaro;Iwata Daiju;Mizuuchi Kazuomi;Kitaichi Nobuyoshi; Mizuki Nobuhisa;Ishida Susumu
目的阐明眼部结节病伴严重、难治性和长期炎症的比例及其与眼部并发症和视力预后的关系。研究设计多中心、回顾性、纵向队列研究。（45名男性; 119名女性）患有眼部结节病，于2010年至2015年在北海道大学医院和横滨市立大学医院就诊。我们新定义的严重，难治性，长期炎症眼结节病，并调查其比例，眼部并发症和最终视力从我们的结节病patients.ResultsThe严重炎症的眼睛编号72/323（22.3%），难治性炎症，80/323（24.8%），和长期炎症，91/323（28.2%）的医疗记录。无重度、难治性或长期炎症（定义为无）的患眼数量为114/323（35.3%）。严重炎症患者中，6/72（8.3%）眼达到不可逆性视觉功能障碍，难治性炎症患者中，10/80（12.5%）眼达到不可逆性视觉功能障碍，长期炎症患者中，12/91（13.2%）眼达到不可逆性视觉功能障碍，无炎症患者中，4/114（6.2%）眼达到不可逆性视觉功能障碍。并发症包括白内障（62.2%）、青光眼（28.5%）、视网膜前膜（24.1%）、黄斑囊样水肿（22.6%）、玻璃体积血（2.8%）、脉络膜萎缩（2.5%）、黄斑变性（1.2%）、黄斑裂孔（0.9%）和视网膜脱离（0.3%）。其中，继发性青光眼（16只眼）和黄斑变性（4只眼）的主要并发症相关的不可逆的visualdysfunction.ConclusionsAlthough大多数的患者与眼部结节病有一个相对较好的视力预后，一些严重的，难治性，和/或长期炎症相关的眼部并发症的发展，导致视力预后不良。
PurposeTo clarify the proportion of ocular sarcoidosis with severe, refractory, and prolonged inflammation and their association with ocular complications and visual prognosis.Study DesignMulticenter, retrospective, longitudinal cohort study.MethodsThree hundred and twenty-three eyes of 164 patients (45 men; 119 women) with ocular sarcoidosis who visited Hokkaido University Hospital and Yokohama City University Hospital from 2010 to 2015. We newly defined severe, refractory, and prolonged inflammation in ocular sarcoidosis, and investigated their proportions, ocular complications and final visual acuity from medical records of our sarcoidosis patients.ResultsThe eyes with severe inflammation numbered 72/323 (22.3%), with refractory inflammation, 80/323 (24.8%), and with prolonged inflammation, 91/323 (28.2%). The number of eyes having neither severe, refractory, nor prolonged inflammation (defined as none) was 114/323 (35.3%). The numbers of eyes that reached irreversible visual dysfunction were 6/72 (8.3%) of those with severe inflammation, 10/80 (12.5%) with refractory inflammation, 12/91 (13.2%) with prolonged inflammation, and 4/114 (6.2%) with none. As complications, cataract (62.2%), glaucoma (28.5%), epiretinal membrane (24.1%), cystoid macular edema (22.6%), vitreous hemorrhage (2.8%), choroidal atrophy (2.5%), macular degeneration (1.2%), macular hole (0.9%) and retinal detachment (0.3%) were identified. Among them, secondary glaucoma (16 eyes) and macular degeneration (4 eyes) were major complications related to irreversible visual dysfunction.ConclusionsAlthough most of the patients with ocular sarcoidosis had a relatively good visual prognosis, some developed severe, refractory, and/or prolonged inflammation related to the development of ocular complications, that resulted in poor visual prognosis.