Ocular Phenotypes in Patients With Hemophagocytic Lymphohistiocytosis: A Retrospective Analysis in a Single Center Over 7 Years
Ocular Phenotypes in Patients With Hemophagocytic Lymphohistiocytosis: A Retrospective Analysis in a Single Center Over 7 Years
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DOI：
10.1016/j.ajo.2023.05.011
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发表时间：
2023-06-16
影响因子：
4.2
通讯作者：
Dong, Ning
中科院分区：
文献类型：
--
作者：
Wang, Luping;Suo, Lingge;Dong, Ning
目的：探讨噬血细胞性嗜酸性组织细胞增生症（HLH）患者眼部异常的存在和类型。设计：回顾性横断面研究。方法：观察报告眼部表现及其与年龄、性别、基础疾病和血液学参数的关系。根据2004年标准定义HLH，患者入组时间为2013年3月至2021年12月。分析于二零二二年七月开始，并于二零二三年一月结束。主要的结果指标是与HLH相关的眼部异常及其潜在的危险因素。结果：1525例HLH患者中，341例有眼部检查，133例（39.00%）有眼部异常。平均发病年龄为30.21岁和14.42岁。多因素分析显示，高龄、自身免疫性疾病、红细胞计数下降、血小板计数下降、维生素C水平升高是HLH患者眼部受累的独立危险因素。最常见的眼部表现为后段异常（66例，49.62%），包括视网膜和玻璃体出血、浆液性视网膜脱离、巨细胞病毒视网膜炎和视盘肿胀。其他HLH相关的眼部异常包括眼表感染结膜炎34例，占25.56%;角膜炎，16例患者，12.03%），结膜下出血水肿11例（8.27%）前葡萄膜炎5例（3.76%）（11例患者，8.27%），糖皮质激素诱导的青光眼（5例患者，3.76%），放射性白内障泪腺炎1例（0.75%）（2例患者，1.50%），泪囊炎眼眶蜂窝织炎2例（1.50%），眼眶假瘤2例（1.50%），斜视2例（1.50%）。布尔;结论：HLH中眼部受累并不罕见。眼科医生和血液科医生的更好的认识是必要的，以及时诊断和适当的管理策略，以挽救视力和生命的潜力机构。(Am J Ophthalmol 2023;253：119-131.&副本; 2023 Elsevier Inc.所有权利重新服务。）
& BULL; PURPOSE: To investigate the presence and type of oc-ular abnormalities in patients with hemophagocytic lym-phohistiocytosis (HLH).& BULL; DESIGN: A retrospective cross-sectional study.& BULL; METHODS: Observational report of ocular findings and their associations with age, sex, underlying disease, and hematologic parameters. HLH was defined according to the 2004 criteria, and the patients were enrolled from March 2013 to December 2021. Analysis began in July 2022 and ended in January 2023. The main outcome measures were ocular abnormalities associated with HLH and their potential risk factors.& BULL; RESULTS: Of 1525 HLH patients, 341 had ocular ex-aminations, and 133 (133 of 341, 39.00%) had ocu-lar abnormalities. Mean age at presentation was 30.21 & PLUSMN; 14.42 years. The multivariate analysis indicated that old age, autoimmune disorders, decreasing red blood cell count, decreasing platelet count, and increasing fibrino-gen level were independent risk factors of ocular involve-ment in HLH patients. The most common presenting oc-ular findings were posterior segment abnormalities (66 patients, 49.62%), including retinal and vitreous hem-orrhage, serous retinal detachment, cytomegalovirus re-tinitis, and optic disc swelling. Other HLH-associated ocular abnormalities included ocular surface infection (conjunctivitis, 34 patients, 25.56%; keratitis, 16 patients, 12.03%), subconjunctival hemorrhage (11 pa-tients, 8.27%), chemosis (5 patients, 3.76%), ante-rior uveitis (11 patients, 8.27%), glucocorticoid-induced glaucoma (5 patients, 3.76%), radiation cataract (1 pa-tient, 0.75%), dacryoadenitis (2 patients, 1.50%), dacry-ocystitis (1 patients, 0.75%), orbital cellulitis (2 patients, 1.50%), orbital pseudotumor (2 patients, 1.50%), and strabismus (2 patients, 1.50%).& BULL; CONCLUSIONS: Eye involvement is not uncommon in HLH. Better awareness among both ophthalmolo-gists and hematologists is necessary for prompt diagno-sis and institution of appropriate management strategies with potential to save sight and life. (Am J Ophthalmol 2023;253: 119-131.& COPY; 2023 Elsevier Inc. All rights re-served.)