Ocular morbidities of juvenile idiopathic arthritis-associated uveitis in adulthood: results from a tertiary center study
Ocular morbidities of juvenile idiopathic arthritis-associated uveitis in adulthood: results from a tertiary center study
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DOI：
10.1007/s00417-016-3340-z
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发表时间：
2016-09-01
影响因子：
2.7
通讯作者：
Foster, C. Stephen
中科院分区：
文献类型：
--
作者：
Oray, Merih;Khachatryan, Naira;Foster, C. Stephen
为了描述幼年特发性关节炎（JIA）相关葡萄膜炎在成人中的临床和视力结果，并检查成年期持续炎症的危险因素，回顾了末次访视（数据收集前的末次访视）时年龄> 16岁的JIA相关葡萄膜炎患者的病历，共纳入77例患者（70例女性，7例男性）的135只眼。末次访视时患者的平均年龄为29.72 ± 11.27岁。末次访视时视力为屈光不正体征20/50和屈光不正体征20/200的患眼数量分别为37只（28%）和20只（15%）; 72%的患眼存在至少一种眼部并发症。带状角膜病变是最常见的并发症（42%），其次是白内障（25%），后粘连（22%），黄斑病变（22%），高眼压（13%）和低眼压（5%）。在最后一次访视时，在马萨诸塞州眼科研究和外科研究所就诊时年龄> 16岁的患者比年龄<16岁的患者有更多的眼部并发症和更大程度的视力丧失。在40例患者（52%）中观察到末次访视时炎症持续存在。在单变量分析中，存在后粘连、张力减退、就诊时白内障以及就诊前有白内障手术史可预测成年期持续性炎症。在多变量分析中，低眼压和后粘连的存在是预测因素。JIA相关的葡萄膜炎可能与成年后持续的炎症、眼部并发症和严重的视力损害有关。初次就诊时存在虹膜后粘连和张力减退预示着炎症持续存在。
To describe the clinical and visual outcomes of juvenile idiopathic arthritis (JIA)-associated uveitis in adults and to examine risk factors for ongoing inflammation in adulthood.Medical records were reviewed for patients with JIA-associated uveitis who were > 16 years old at the final visit (the last visit prior to data collection).In total, 135 eyes of 77 patients (70 female, 7 male) were included. The mean age of patients at the final visit was 29.72 +/- 11.27 years. The number of eyes with visual acuity of aecurrency sign20/50 and aecurrency sign20/200 at the final visit was 37 (28 %) and 20 (15 %), respectively; at least one ocular complication was present in 72 % of eyes. Band keratopathy was the most frequent complication (42 %), followed by cataract (25 %), posterior synechiae (22 %), maculopathy (22 %), ocular hypertension (13 %), and hypotony (5 %). At the final visit, patients who were > 16 years of age at presentation to the Massachusetts Eye Research and Surgery Institution had more ocular complications and a greater degree of vision loss than patients who were aecurrency sign16 years of age. Ongoing inflammation at the final visit was noted in 40 patients (52 %). The presence of posterior synechiae, hypotony, cataract at presentation, and a history of cataract surgery prior to presentation were predictive of ongoing inflammation in adulthood in univariate analysis. The presence of hypotony and posterior synechiae at the initial visit were predictive factors in multivariate analysis.JIA-associated uveitis may be associated with ongoing inflammation, ocular complications, and severe visual impairment in adulthood. The presence of posterior synechiae and hypotony at the initial visit is predictive of ongoing inflammation.