Degree, duration, and causes of visual loss in uveitis
Degree, duration, and causes of visual loss in uveitis
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DOI：
10.1136/bjo.2003.037226
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发表时间：
2004-09-01
影响因子：
4.1
通讯作者：
Murray, PI
中科院分区：
文献类型：
--
作者：
Durrani, OM;Tehrani, NN;Murray, PI
背景/目的：葡萄膜炎是工作年龄人群视力发病的主要原因。作者调查了葡萄膜炎患者视力丧失的持续时间、程度和原因，目的是更好地定义视力发病率和识别潜在的危险因素。方法：对315例连续三级转诊葡萄膜炎患者进行回顾性、非介入性、观察性调查。结果：平均随访36.7个月。120例患者有视力（6/60），其中220/315例（69.95%）出现视力下降（6/18）。单侧视力丧失109例（49.54%），双侧视力丧失111例（50.45%）。视力丧失的平均时间为21个月。148例泛葡萄膜炎患者中，125例（84.45%）视力下降，66例（53%）视力正常（6/60）。视力丧失的主要原因为黄斑囊样水肿（CMO）（59/220, 26.8%）、白内障（39/220,17.7%）和CMO合并白内障（44/220,20%）。以下因素可预测较差的视力预后：泛葡萄膜炎（p = 0.0005）、双侧炎症（p = 0.0005）、视力下降持续时间延长（p = 0.0005）、印度或巴基斯坦种族背景（p = 0.004）和患者年龄增加（p = 0.02）。结论：三分之二的葡萄膜炎患者出现长期视力丧失，70例（22%）患者在随访中达到法定失明标准。伴有双侧炎症和视力下降持续时间延长的老年患者发生严重视力丧失的风险最大（6/60）。CMO和白内障导致64.5%的患者视力下降。
Background/aims: Uveitis is a major cause of visual morbidity in the working age group. The authors investigated the duration, degree, and causes of visual loss in uveitis patients with the aim of better defining the visual morbidity and identifying potential risk factors.Methods: A retrospective, non-interventional, observational survey of 315 consecutive patients attending a tertiary referral uveitis service.Results: The mean duration of follow up was 36.7 months. Reduced vision (( 6/18) was found in 220/315 (69.95%) of the patients with a subset of 120 patients having vision (6/60. Unilateral visual loss occurred in 109 (49.54%), while 111 (50.45%) had bilateral loss. The mean duration of visual loss was 21 months. Of the 148 patients with pan-uveitis, 125 (84.45%) had reduced vision, with 66 (53%) having vision (6/60. Main causes of visual loss were cystoid macular oedema (CMO) (59/220, 26.8%), cataract (39/220, 17.7%), and combination of CMO and cataract (44/220, 20%). The following were predictive of a poorer visual prognosis: pan-uveitis (p = 0.0005), bilateral inflammation ( p = 0.0005), increasing duration of reduced vision (p = 0.0005), an Indian or Pakistani ethnic background ( p = 0.004), and increasing patient age (p = 0.02).Conclusion: Prolonged visual loss occurred in two thirds of uveitis patients, with 70 (22%) patients meeting the criteria for legal blindness at some point in their follow up. Older patients with bilateral inflammation and an increasing duration of reduced vision are at the greatest risk of severe visual loss ((6/60). CMO and cataract were responsible for visual loss in 64.5% of patients.