Causes of uveitis in the general practice of ophthalmology
Causes of uveitis in the general practice of ophthalmology
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DOI：
10.1016/s0002-9394(14)70532-x
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发表时间：
1996-01-01
影响因子：
4.2
通讯作者：
Yang, MC
中科院分区：
文献类型：
--
作者：
McCannel, CA;Holland, GN;Yang, MC
目得：大多数葡萄膜炎病例系列来自三级医疗中心，他们报告的疾病的相对频率可能反映了转诊偏倚。我们寻求信息的葡萄膜炎的类型遇到的一般practice of ophthalmology.METHODS：我们前瞻性地检查了213 concentive的情况下，一般葡萄膜炎，定义为眼内炎症以外的巨细胞病毒视网膜病变，看到一组社区为基础的综合眼科医生。将这组病例与同一社区一所大学转诊中心的葡萄膜炎专家检查的213例连续的一般葡萄膜炎病例进行比较。所有病例均根据炎症的解剖部位和病程进行分类，如果可能的话，他们被分配了一个特定的诊断。在相同的时间间隔内观察到的巨细胞病毒视网膜病变和伪装综合征的病例分别记录。结果：在以社区为基础的实践中，一般性葡萄膜炎病例按疾病解剖部位的分布有显著差异（前部，90.6%;中间，1.4%;后部，4.7%;全葡萄膜炎，1.4%）和大学转诊实践（前部，60.6%;中部，12.2%;后部，14.6%;全葡萄膜炎，9.4%; P < .00005）。原因或临床综合征可以分配给47.4%的情况下，以社区为基础的做法，并在大学转诊实践中的57.8%的情况下（P = 0.03）。HLA-B27相关的前葡萄膜炎，巨细胞病毒性视网膜病变，弓形体视网膜脉络膜炎是五种最常见的形式的葡萄膜炎在这两个实践setting.CONCLUSION：各种形式的葡萄膜炎的相对频率被认为是在三级转诊中心不一定反映了眼科医生的经验，该中心所在的社区。前葡萄膜炎和突发性疾病构成了社区综合眼科医生看到的病例的较大比例。
PURPOSE: Most uveitis case series have come from tertiary care centers, and the relative frequencies of disorders they report may reflect referral bias. We sought information about the types of uveitis encountered in the general practice of ophthalmology.METHODS: We prospectively examined 213 con secutive cases of general uveitis, defined as intraocular inflammation other than cytomegalovirus retinopathy, seen by a group of community-based comprehensive ophthalmologists. This group of cases was compared with 213 consecutive cases of general uveitis examined by a uveitis specialist at a university referral center in the same community. All cases were categorized by anatomic site of inflammation and disease course, and, if possible, they were assigned a specific diagnosis. Cases of cytomegalovirus retinopathy and masquerade syndrome seen during the same intervals were recorded separately.RESULTS: The distribution of general uveitis cases by anatomic site of disease was significantly different between the community-based practices (anterior, 90.6%; intermediate, 1.4%; posterior, 4.7%; panuveitis, 1.4%) and the university referral practice (anterior, 60.6%; intermediate, 12.2%; posterior, 14.6%; panuveitis, 9.4 %; P < .00005). A cause or clinical syndrome could be assigned to 47.4% of cases in the community-based practices, and to 57.8% of cases in the university referral practice (P = .03). HLA-B27-associated anterior uveitis, cytomegalovirus retinopathy, and toxoplasmic retinochoroiditis were among the five most common forms of uveitis in both practice settings.CONCLUSION: The relative frequencies with which various forms of uveitis are seen in a tertiary referral center do not necessarily reflect the experience of ophthalmologists from the community in which the center is located. Anterior uveitis and disorders of sudden onset constitute a greater proportion of cases seen by community based comprehensive ophthalmologists.