Uveitis associated with an epidemic outbreak of leptospirosis
Uveitis associated with an epidemic outbreak of leptospirosis
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DOI：
10.1016/s0002-9394(14)71646-0
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发表时间：
1997-07-01
影响因子：
4.2
通讯作者：
Namperumalsamy, P
中科院分区：
文献类型：
--
作者：
Rathinam, SR;Rathnam, S;Namperumalsamy, P
目的：定义临床环境中与钩端螺旋体病相关的葡萄膜炎。方法：我们介绍了 1994 年 1 月至 9 月期间检查的 73 例连续葡萄膜炎病例的临床特征，这些葡萄膜炎在临床上与系统性钩端螺旋体病爆发相关，这些患者中有钩端螺旋体抗体，这些患者均在 1994 年 1 月至 9 月进行检查。结果：在 73 名患者中，35 名患者出现单侧眼部受累，38 名患者出现双侧眼部受累。 106只眼（95.5%），视网膜静脉周围炎57只眼（51.4%），前房积脓14只眼（12.6%）。 3只眼（2.7%）仅观察到前葡萄膜炎而无前房积脓，而仅观察到玻璃体炎症反应的有2只眼（1.8%）。 73 名患者中的 60 名 (82.2%) 或 111 只眼睛中的 91 只眼睛 (82.0%) 接受了为期 8 个月的随访。 47 只眼 (52%) 的最终视力为 6/6 (20/20)，并在治疗期间有所改善，但 15 只眼 (16%) 的视力未达到 6/6。 28只眼（31%）视力保持不变，1只眼视力下降。结论：钩端螺旋体病相关葡萄膜炎可表现为单侧或双侧葡萄膜炎、前葡萄膜炎或全葡萄膜炎。即使炎症严重，该实体的预后通常良好。在流行地区对这种疾病的认识非常重要，以便将其与其他葡萄膜炎实体区分开来，特别是在年轻男性患者中，其他免疫性葡萄膜炎也很常见。
PURPOSE: To define uveitis associated with leptospirosis in a clinical setting.METHODS: We present the clinical features of 73 consecutive cases of uveitis linked clinically to an outbreak of systemic leptospirosis in patients with antibodies to Leptospira species who were examined from January to September 1994.RESULTS: In 73 patients, the pattern of ocular involvement was unilateral in 35 and bilateral in 38. Panuveitis was seen in 106 eyes (95.5%), retinal periphlebitis in 57 eyes (51.4%), and hypopyon in 14 eyes (12.6%). Anterior uveitis alone without hypopyon was observed in three eyes (2.7%), whereas vitreous inflammatory reaction alone was seen in two eyes (1.8%). Sixty of 73 patients (82.2%) or 91 of 111 eyes (82.0%) were followed up for 8 months. Final visual acuity was 6/6 (20/20) in 47 eyes (52%) and improved during treatment, although not up to 6/6, in 15 eyes (16%). Twenty-eight eyes (31%) maintained same vision, and one eye showed deterioration of vision.CONCLUSION: Uveitis associated with leptospirosis may manifest as unilateral of bilateral uveitis, anterior uveitis, or panuveitis. The prognosis is generally good in this entity, even when the inflammation is severe. Awareness of this disease in endemic areas is important in order to differentiate it from other uveitic entities, especially in young male patients in whom other immunologic uveitides are also common.