The ocular and systemic prognosis of patients presenting with sarcoid uveitis
The ocular and systemic prognosis of patients presenting with sarcoid uveitis
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DOI：
10.1038/eye.1999.221
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发表时间：
1999-12-01
期刊：
影响因子：
3.9
通讯作者：
Graham, EM
中科院分区：
文献类型：
--
作者：
Edelsten, C;Pearson, A;Graham, EM
目的描述结节性色素层炎患者的视觉和全身结局。方法对75例确诊或疑似结节性色素层炎的患者进行了中位4年的随访。患者来自初级眼科转诊中心和葡萄膜炎专科中心。研究了发病时人口统计学和临床特征的预后价值。结果10年后，54%的患者视力保持正常，4.6%的患者双眼视力下降至6/36以下。51%的患者需要口服类固醇治疗葡萄膜炎，另有11%的患者需要额外的免疫抑制剂。21%的病人接受了外科手术。在葡萄膜炎发病时，肺是最常见的受累器官（35%）。10年随访后，13例患者（17%）的疾病扩散到其他器官; 13例患者中有8例是中枢神经系统。与基线变量相关的唯一结果是双侧视力丧失，这在40岁以上的患者中更有可能发生（p = 0.004）。结论结节性葡萄膜炎的眼部预后与发病时疾病的程度无关。眼外疾病患者的表现与孤立性眼病患者没有区别。结节病葡萄膜炎患者至少有15年的神经系统受累风险。
Purpose To describe the visual and systemic outcomes in patients presenting with sarcoid uveitis.Methods Seventy-five patients with definite or presumed sarcoid uveitis were followed up for a median of 4 years. The patients came from a primary ophthalmic referral centre and a specialist uveitis centre. The prognostic value of demographic and clinical features at the onset of disease were studied. Baseline and outcome variables were analysed by survival analysis.Results After 10 years, 54% of patients retained normal visual acuity and 4.6% had lost vision to less than 6/36 in both eyes. Fifty-one per cent required oral steroids for uveitis and a further 11% needed additional immunosuppressants. Twenty-one per cent of patients had undergone a surgical procedure. At the onset of uveitis the lung was the most common organ involved (35%). After 10 years follow-up disease spread to other organs in 13 patients (17%); in 8 of 13 patients this was the central nervous system. The only outcome associated with baseline variables was bilateral visual loss, which was more likely in those over 40 years at presentation (p = 0.004).Conclusions The ocular prognosis of sarcoid uveitis is unrelated to the extent of disease at onset. Patients with extraocular disease fared no differently from those with isolated ocular disease. Patients with sarcoid uveitis are at risk of neurological involvement for at least 15 years.