Incidence and Risk Factors of Recurrent Anterior Uveitis in Initial Acute-Onset Vogt-Koyanagi-Harada Disease.

Yeon Ju Lim, Iksoo Byon, Hyun Woong Kim, Sung Who Park, Han Jo Kwon, EunAh Kim
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Abstract

Purpose: We report the estimated incidence of, and risk factors for, recurrent anterior uveitis in patients with initial acute-onset Vogt-Koyanagi-Harada (VKH) disease using survival analyses.

Methods: Patients who were diagnosed with initial acute-onset VKH disease during 2003-2022 at two university hospitals were included. Recurrent anterior uveitis was defined as the first occurrence of the granulomatous anterior uveitis with anterior chamber cells and flare of 2+ or more by the Standardization of Uveitis Nomenclature (SUN) Working Group grading scheme, after the disappearance of conspicuous uveitis and serous retinal detachment for at least 3 months, regardless of systemic or local treatment. The univariate log-rank test and multivariate Cox regression analyses were performed, including patients' demographic characteristics, underlying diseases, presence of prodromal symptoms, duration of visual symptoms, visual acuity, slit-lamp and fundus findings, and height of serous retinal detachment. The treatment method and response to treatment were also included.

Results: The estimated incidence was 39.3% at 10 years. Fifteen of 55 patients (27.3%) had recurrent anterior uveitis during the mean follow-up of 4.5 years. The presence of focal posterior synechiae at the diagnosis increased the risk of recurrent anterior uveitis 6.97-fold compared to the absence of synechiae (95% confidence interval [CI], 2.20-22.11; p < 0.001). Use of systemic high-dose steroid therapy more than 7 days after the development of visual symptoms resulted in a hazard ratio of 4.55 (95% CI, 1.27-16.40; p = 0.020).

Conclusions: This study reports the estimated incidence and risk factors of recurrent anterior uveitis in VKH disease from survival analyses. However, because of the retrospective nature of this study, it is hard to confirm the consistency of the medical records regarding risk factors, thus, the presence of focal posterior synechiae can be inconclusive as a risk factor. Further studies are warranted.

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急性Vogt-Koyanagi-Harada病复发性前葡萄膜炎的发生率及危险因素
目的:我们通过生存分析报告初始急性发作Vogt-Koyanagi-Harada (VKH)病患者复发性前葡萄膜炎的估计发生率和危险因素。方法:选取2003-2022年在两所大学医院诊断为初发急性VKH病的患者。复发性葡萄膜炎定义为:根据葡萄膜炎命名标准化工作组(SUN)分级方案,在显著性葡萄膜炎和浆液性视网膜脱离消失至少3个月后,首次出现伴有前房细胞和2+以上光斑的肉芽肿性葡萄膜前炎,无论是否进行全身或局部治疗。进行单因素log-rank检验和多因素Cox回归分析,包括患者的人口学特征、基础疾病、前症症状的存在、视觉症状的持续时间、视力、裂隙灯和眼底检查以及浆液性视网膜脱离的高度。包括治疗方法和治疗反应。结果:10年估计发病率为39.3%。55例患者中有15例(27.3%)在平均4.5年的随访期间复发前葡萄膜炎。诊断时有局灶性后粘连比无粘连增加了前葡萄膜炎复发的风险6.97倍(95%可信区间[CI], 2.20-22.11;p & lt;0.001)。在出现视觉症状后超过7天使用全体性大剂量类固醇治疗导致的风险比为4.55 (95% CI, 1.27-16.40;P = 0.020)。结论:本研究从生存分析中报告了VKH疾病复发性前葡萄膜炎的估计发生率和危险因素。然而,由于本研究是回顾性的,很难确认关于危险因素的医疗记录的一致性,因此,局灶性后粘连的存在可能是一个不确定的危险因素。进一步的研究是必要的。
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来源期刊
Korean Journal of Ophthalmology : KJO
Korean Journal of Ophthalmology : KJO Medicine-Ophthalmology
CiteScore
2.40
自引率
0.00%
发文量
84
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