A 15-Year Review of Ocular Manifestations of Autoimmune Inflammatory Disorders in a University Hospital

Gerald B Natanauan, J. Li-Yu, Jessica C Daza-Robes, J. M. Abaño
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Abstract

Background: Autoimmune diseases represent a significant health burden for 3% to 9% of the general population, and rheumatology, perhaps more than any other medical subspecialty, encompasses a broad array of such diseases that affect a wide range of organ systems including the eye. It serves as a sensitive barometer of autoimmune phenomena in many of the rheumatic diseases. Objective: The study determined the various ocular manifestations of all autoimmune inflammatory disorders at the University of Santo Tomas Hospital, Section of Rheumatology and the Department of Ophthalmology from 2003 to 2018. Methodology: A retrospective cohort study was done involving chart review of patients from both private division and clinical division. Sex, age, duration of disease, medications given, and ocular manifestations were determined. Statistical analysis included frequencies, percentages, and logistic regression analysis. Results: Sixty-seven patients were included in the study. Of these, 58.2% (39/67) had ocular manifestations secondary to an established autoimmune disease. It was found out that 58.97% (23/39) had Vogt-Koyanagi-Harada syndrome. Other autoimmune diseases with ophthalmologic manifestations were systemic lupus erythematosus at 12.8% (5/39), ankylosing spondylitis at 10.25% (4/39), rheumatoid arthritis and Behcet’s syndrome at 5.12% (2/39), and granulomatosis with polyangiitis, scleroderma and psoriatic arthritis at 2.56% (1/39). Conclusion: In this population, the frequency of ocular manifestations of autoimmune diseases remained low with anterior uveitis as the most common. Close coordination between specialties is very important in the course of treatment and management to lessen its complications and related morbidity.
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某大学医院自身免疫性炎症性疾病眼部表现15年回顾
背景:自身免疫性疾病是普通人群中3%至9%的重大健康负担,而风湿病学可能比任何其他医学专科都要多,涵盖了广泛的此类疾病,影响包括眼睛在内的广泛器官系统。它是许多风湿性疾病自身免疫现象的敏感晴雨表。目的:研究2003 - 2018年圣托马斯大学医院风湿病科和眼科所有自身免疫性炎症性疾病的各种眼部表现。方法:采用回顾性队列研究,对来自私人科室和临床科室的患者进行图表回顾。确定患者的性别、年龄、病程、用药情况和眼部表现。统计分析包括频率、百分比和逻辑回归分析。结果:67例患者纳入研究。其中,58.2%(39/67)有继发于自身免疫性疾病的眼部表现。58.97%(23/39)的患者有Vogt-Koyanagi-Harada综合征。其他以眼部为表现的自身免疫性疾病为系统性红斑狼疮12.8%(5/39),强直性脊柱炎10.25%(4/39),类风湿关节炎和白塞综合征5.12%(2/39),肉芽肿病合并多血管炎、硬皮病和银屑病关节炎2.56%(1/39)。结论:在这一人群中,自身免疫性疾病眼部表现的频率仍然很低,以前葡萄膜炎为最常见。在治疗和管理过程中,各专科之间的密切配合对于减少其并发症和相关发病率非常重要。
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