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Causal Relationship Between Autoimmune Rheumatic Diseases and Iridocyclitis: A Bidirectional Two-Sample Mendelian Randomization Study.
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-23 DOI: 10.1080/09273948.2025.2455965
Minghui Wang, Gongfei Li

Purpose: This study aims to explore the relationship between autoimmune rheumatic diseases (ARDs) and the risk of iridocyclitis (IC) using Mendelian randomization (MR) analysis.

Methods: Data of ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), juvenile idiopathic arthritis (JIA), Behcet's disease (BD), and iridocyclitis were obtained from genome-wide association studies with large sample sizes. The instrumental variable utilized in this study for each exposure was the single nucleotide polymorphism. The inverse-variance weighted (IVW) method, which included random effects, was used to analyze causal effects. In addition, sensitivity analyses were conducted using the weighted median and MR-Egger methods. The presence of pleiotropic effects was identified and addressed through MR pleiotropic effects residual and outlier tests, as well as MR-Egger modeling.

Results: We found a causal effect of AS (IVW, OR = 2.74 × 1029, 95% CI 6.39 × 107 - 1.18 × 1051, p = 0.008) on IC. Conversely, we also found a causal effect of IC on AS (IVW OR = 1.01, 95% CI 1.00 - 1.01, p < 0.001). Besides, sensitivity analysis showed no evidence of pleiotropy and heterogeneity. However, no causal relationship between SLE, JIA, BD, and IC was detected.

Conclusion: Bilateral causal relationships of IC and AS were identified, which could offer evidence for clinical use and lay the groundwork for detecting potential mechanism behind them.

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引用次数: 0
HLA-G Polymorphisms of The 3'-UTR Region Are Involved in Susceptibility to Non-Infectious Uveitis. 3'-UTR区HLA-G多态性与非感染性葡萄膜炎易感性有关
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-21 DOI: 10.1080/09273948.2025.2455969
Marta Molina-Alejandre, Ignacio Juárez, Christian Vaquero-Yuste, Marina Gorroño-Echebarría, Elisa María Molanes-López, Eduardo Fernandez-Cruz, Carmen Rodriguez-Sainz, Antonio Arnaiz-Villena, José Manuel Martin-Villa

Purpose: HLA-G is a non-classical HLA class I gene encoding a molecule endowed with immunomodulatory properties, playing important immunosuppressive and tolerogenic roles in immuno-privileged organs. Fluctuations in its expression levels have been correlated with the predisposition to autoinflammatory disorders, notably uveitis, characterized by inflammation of the uvea. In the present work, DNA was obtained from saliva samples of 147 Spanish patients with uveitis, with subsequent analysis focusing on the distribution of polymorphisms within the 3'UTR region of the HLA-G gene (a region known to modulate the expression of the HLA-G molecule).

Methods: Analysis techniques employed included PCR-RFLP or DNA sequencing. Comparative analysis was conducted against a control cohort comprising 117 healthy individuals.

Results: The frequency of the UTR-2 haplotype is increased in patients affected with anterior uveitis (OR (95% CI) 2.35 (1.06-5.21); p = 0.036). Additionally, a higher number of patients with posterior uveitis bearing in homozygosis the G allele of the 3142 C/G SNP (OR (95% CI) 2.67 (1.15-6.20); p = 0.023), was observed. Both markers are associated with diminished HLA-G expression.

Conclusion: These findings present the first evidence of the involvement of polymorphisms within the 3'UTR region of the HLA-G gene in susceptibility to uveitis.

目的:HLA- g是一种非经典HLA I类基因,编码具有免疫调节特性的分子,在免疫特权器官中起重要的免疫抑制和耐受原作用。其表达水平的波动与自身炎症性疾病的易感性相关,特别是葡萄膜炎,其特征是葡萄膜炎症。在目前的工作中,从147名西班牙葡萄膜炎患者的唾液样本中获得DNA,随后的分析重点是HLA-G基因3'UTR区域(已知调节HLA-G分子表达的区域)内多态性的分布。方法:采用PCR-RFLP或DNA测序等分析技术。与117名健康个体组成的对照队列进行比较分析。结果:UTR-2单倍型在前葡萄膜炎患者中出现的频率增加(OR (95% CI) 2.35 (1.06-5.21);p = 0.036)。此外,较多的后葡萄膜炎患者携带3142 C/G SNP的G等位基因纯合子(OR (95% CI) 2.67 (1.15-6.20);P = 0.023)。这两种标记都与HLA-G表达减少有关。结论:这些发现提供了HLA-G基因3'UTR区域多态性参与葡萄膜炎易感性的第一个证据。
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引用次数: 0
Barriers to Adherence with Clinic Visits in Patients with Uveitis. 葡萄膜炎患者坚持就诊的障碍。
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-20 DOI: 10.1080/09273948.2025.2456641
Karen Sun, Rayna Marshall, Michael Frankland, Amal Taylor, Cynthia Montana, Eric Crowell, Karen R Armbrust, Laura Kopplin, Meghan Berkenstock

Purpose: To assess the patient barriers to adherence with appointment follow-up in patients with ocular inflammatory disorders across the United States.

Methods: This was a multicenter study of adult and pediatric patients at the Wilmer Eye Institute, University of Texas at Austin, University of Wisconsin-Madison, University of Minnesota, Minneapolis Veterans Administration Hospital, and Washington University of St. Louis. The primary outcome was self-reported adherence to follow-up visits. Secondary outcomes were the reasons for missing follow-up including sub analyses of patient demographics. Eligible patients completed a self-reporting survey to assess barriers to attending follow-up visits.

Results: The survey was fully completed by 210 subjects and partially by 40 (250 in total), of whom were 67% white, 59% female, and 51% had a college or advanced degree. Most patients had bilateral (68%), anterior (51%) uveitis. Patients were treated with topical corticosteroids (33%), immunosuppressive agents (23%), or both (22%). Most patients (79%) did not miss or cancel appointments. Ninety-seven percent of patients had medical insurance and some paid (39%) more than 40 dollars for their copay. Copay costs limited the number of visits patients could attend in 7% of patients. Eight percent of patients missed appointments due to inability to take off time from work and 5% missed visits due to lack of transportation.

Conclusion: Most patients with ocular inflammation reported good adherence to follow-up appointments. Insurance type, copay costs, transportation, patient scheduling, and patient understanding were all minimally reported to effect patient visit attendance.

目的:评估美国眼部炎症性疾病患者遵守预约随访的障碍。方法:这是一项多中心研究,包括威尔默眼科研究所、德克萨斯大学奥斯汀分校、威斯康星大学麦迪逊分校、明尼苏达大学、明尼阿波利斯退伍军人管理医院和圣路易斯华盛顿大学的成人和儿科患者。主要结果是自我报告的随访依从性。次要结局是缺少随访的原因,包括患者人口统计学的亚组分析。符合条件的患者完成了一项自我报告调查,以评估参加随访的障碍。结果:210人完全完成了调查,40人(共250人)部分完成了调查,其中白人67%,女性59%,51%拥有大学或高等学位。大多数患者有双侧(68%)和前侧(51%)葡萄膜炎。患者接受外用皮质类固醇(33%)、免疫抑制剂(23%)或两者兼用(22%)。大多数患者(79%)没有错过或取消预约。97%的患者有医疗保险,有些人(39%)支付了超过40美元的共付费用。共付费用限制了7%患者的就诊次数。8%的患者因无法请假而错过预约,5%的患者因交通不便而错过就诊。结论:大多数眼部炎症患者的随访依从性良好。据报道,保险类型、共付费用、交通、患者日程安排和患者理解对患者就诊出勤率的影响最小。
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引用次数: 0
Intermediate Uveitis: An Updated Review of the Differential Diagnosis and Relevant Special Investigations. 中级葡萄膜炎:鉴别诊断和相关特殊检查的最新综述。
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-14 DOI: 10.1080/09273948.2025.2450473
Jacob Biju Mark, Derrick P Smit, Rajashree E, Rathinam Sr

The aim of this review is to provide an update on both the differential diagnosis of intermediate uveitis (IU) and the special investigations that may be required to determine the underlying etiology of this condition. The authors describe how they identified the relevant publications included in this review and then proceed to outline the possible causes of IU by classifying them into the following categories: Idiopathic, infectious, systemic, genetic/hereditary, drug-induced and masquerades. Thereafter, the special investigations relevant to each cause are discussed individually.

本综述的目的是提供中间葡萄膜炎(IU)的鉴别诊断和可能需要的特殊调查的最新信息,以确定这种情况的潜在病因。作者描述了他们如何识别本综述中包括的相关出版物,然后通过将其分为以下几类来概述IU的可能原因:特发性、感染性、全身性、遗传/遗传、药物诱导和假面性。然后,分别讨论与每个原因相关的特殊调查。
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引用次数: 0
Presumed Sympathetic Ophthalmia After Diode Laser Cyclophotocoagulation for Neovascular Glaucoma: A Case Series. 二极管激光循环光凝治疗新生血管性青光眼后推定的交感性眼炎:一个病例系列。
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-13 DOI: 10.1080/09273948.2024.2447838
Blanca C Flores-Sánchez, Katharine S Sears

Purpose: To describe a case series of presumed Sympathetic Ophthalmia (SO) triggered by diode laser cyclophotocoagulation (CPC) for the treatment of neovascular glaucoma.

Methods: Patients developing bilateral granulomatous uveitis after CPC between 2014 and 2024. Cases with prior ocular trauma or penetrating ocular surgery were excluded. Treatment consisted of systemic steroids acutely and subsequently steroid-sparing drugs for long-term control.

Results: Three patients were included. The cause of neovascular glaucoma in the inciting eyes was a central retinal vein occlusion. The ocular inflammation was characterised by vitritis, serous retinal detachment, and choroidal thickening. The follow-up for each case was 2, 6 and 10 years, respectively. During this period, all patients remained under constant immunosuppression due to recurrence of inflammation while attempting tapering of systemic therapy after a period of clinical stability. The final best-corrected visual acuity of the sympathising eyes was ≥6/9 Snellen and there was no perception of light in the inciting eyes. The blind eyes were comfortable and did not require surgical removal.

Conclusions: Patients responded well to prompt immunosuppression and preserved vision in the sympathising eye. Steroid-sparing medication could not be stopped due to inflammation flare-ups and risk of visual loss. There could be a potential link between breakdown of the blood-retina barrier prior to the development of SO and sustained inflammatory reaction.

目的:报道用二极管激光光凝(CPC)治疗新生血管性青光眼引发交感性眼炎(SO)的病例。方法:2014 ~ 2024年CPC术后发生双侧肉芽肿性葡萄膜炎的患者。既往有眼部外伤或眼部穿透手术的病例被排除在外。治疗包括急性全身性类固醇,随后使用类固醇保留药物进行长期控制。结果:纳入3例患者。诱发眼新生血管性青光眼的原因是视网膜中央静脉阻塞。眼部炎症表现为玻璃体炎、浆液性视网膜脱离和脉络膜增厚。每个病例的随访时间分别为2年、6年和10年。在此期间,由于炎症复发,所有患者都处于持续的免疫抑制状态,并在临床稳定一段时间后尝试逐渐减少全身治疗。交感眼最终最佳矫正视力≥6/9 Snellen,刺激眼无光感。失明的眼睛很舒服,不需要手术切除。结论:患者对及时的免疫抑制反应良好,交感眼视力得以保留。由于炎症发作和视力丧失的风险,类固醇药物不能停止。在SO发生之前,血视网膜屏障的破坏与持续的炎症反应之间可能存在潜在的联系。
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引用次数: 0
Intraocular Metastatic Lung Adenocarcinoma Masquerading as an Intermediate Uveitis. 伪装成中度葡萄膜炎的眼内转移性肺腺癌。
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-13 DOI: 10.1080/09273948.2024.2447846
Robert D Nguyen, Itamar Livnat, Vimal Krishnan, Jay M Stewart, John A Gonzales

Purpose: To report on the clinical and cytopathological features of metastatic lung adenocarcinoma to the eye masquerading as an intermediate uveitis.

Methods: Retrospective chart review.

Results: A 63-year-old woman with a history of lung adenocarcinoma in remission presented with progressive vision loss and floaters in the right eye. Clinically, her uveitis was classified as a non-granulomatous anterior/intermediate uveitis. Pars plana vitrectomy was performed and cytopathology of the vitreous was unremarkable but directed polymerase chain reaction (PCR) was positive for HSV-1. Despite dual antiviral and antibiotic therapy, her visual acuity and intraocular inflammation progressively worsened prompting repeat vitrectomy with cytopathology revealing metastatic adenocarcinoma.

Conclusion: Intraocular metastatic lung adenocarcinoma can masquerade as an intermediate uveitis, presenting significant diagnostic challenges. Early and repeated cytopathological analysis of vitreous samples is crucial when the diagnosis remains uncertain, as it can lead to timely and accurate identification of metastatic carcinoma, thereby improving patient management and outcomes. This case underscores the diagnostic challenges and clinical complexity of distinguishing intraocular metastatic lung adenocarcinoma from intermediate uveitis.

目的:报道伪装成中度葡萄膜炎的转移性肺腺癌的临床和细胞病理学特征。方法:回顾性图表复习。结果:一名63岁女性,有肺腺癌病史,缓解期,表现为进行性视力丧失和右眼飞蚊症。临床上,她的葡萄膜炎被归类为非肉芽肿性前/中间葡萄膜炎。行玻璃体切除,玻璃体细胞病理无明显变化,但定向聚合酶链反应(PCR) HSV-1阳性。尽管双重抗病毒和抗生素治疗,她的视力和眼内炎症逐渐恶化,促使再次玻璃体切除术,细胞病理学显示转移腺癌。结论:眼内转移性肺腺癌可以伪装成中度葡萄膜炎,提出了重大的诊断挑战。当诊断不确定时,对玻璃体样本进行早期和重复的细胞病理学分析至关重要,因为它可以及时准确地识别转移性癌,从而改善患者的管理和预后。本病例强调了鉴别眼内转移性肺腺癌与中度葡萄膜炎的诊断挑战和临床复杂性。
{"title":"Intraocular Metastatic Lung Adenocarcinoma Masquerading as an Intermediate Uveitis.","authors":"Robert D Nguyen, Itamar Livnat, Vimal Krishnan, Jay M Stewart, John A Gonzales","doi":"10.1080/09273948.2024.2447846","DOIUrl":"https://doi.org/10.1080/09273948.2024.2447846","url":null,"abstract":"<p><strong>Purpose: </strong>To report on the clinical and cytopathological features of metastatic lung adenocarcinoma to the eye masquerading as an intermediate uveitis.</p><p><strong>Methods: </strong>Retrospective chart review.</p><p><strong>Results: </strong>A 63-year-old woman with a history of lung adenocarcinoma in remission presented with progressive vision loss and floaters in the right eye. Clinically, her uveitis was classified as a non-granulomatous anterior/intermediate uveitis. Pars plana vitrectomy was performed and cytopathology of the vitreous was unremarkable but directed polymerase chain reaction (PCR) was positive for HSV-1. Despite dual antiviral and antibiotic therapy, her visual acuity and intraocular inflammation progressively worsened prompting repeat vitrectomy with cytopathology revealing metastatic adenocarcinoma.</p><p><strong>Conclusion: </strong>Intraocular metastatic lung adenocarcinoma can masquerade as an intermediate uveitis, presenting significant diagnostic challenges. Early and repeated cytopathological analysis of vitreous samples is crucial when the diagnosis remains uncertain, as it can lead to timely and accurate identification of metastatic carcinoma, thereby improving patient management and outcomes. This case underscores the diagnostic challenges and clinical complexity of distinguishing intraocular metastatic lung adenocarcinoma from intermediate uveitis.</p>","PeriodicalId":19406,"journal":{"name":"Ocular Immunology and Inflammation","volume":" ","pages":"1-4"},"PeriodicalIF":2.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of Reduction of 2% Topical Ganciclovir on Recurrence of Cytomegalovirus Iritis. 局部减少2%更昔洛韦对巨细胞病毒虹膜炎复发的影响。
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-13 DOI: 10.1080/09273948.2024.2446417
Yuta Nariya, Takashi Ono, Takahiro Minami, Makoto Aihara, Rie Tanaka, Takashi Miyai

Purpose: To examine the recurrence of cytomegalovirus (CMV) iritis in patients using low-dose ganciclovir (GCV) eye drops.

Methods: We included patients with dormant CMV iritis who were treated using 2% GCV eye drops at the University of Tokyo Hospital between January and June 2023 and whose dosage of GCV eye drops was required to be reduced due to the unstable GCV supply. Patients were excluded if they had active CMV retinitis and underwent corneal transplantation. We examined the recurrence of CMV iritis after the reduction of GCV eye drops.

Results: Fifteen eyes of 14 patients (mean age, 62.4 ± 13.0 years) were included. The frequency of GCV eye drops was reduced from four times a day to twice in 13 eyes and three times in two eyes. The mean observation period after the reduction of GCV eye drops was 202.5 ± 155.8 days. Although there were no recurrences in the 6 months prior to the reduction of GCV eye drops, recurrences were observed in five eyes (33.3%) after the reduction. The mean time from GCV reduction to recurrence was 59.2 ± 11.3 days. Patients who survived the first 3 months without recurrence had no recurrence later.

Conclusion: Recurrences of CMV iritis were observed in one-third of the eyes within 3 months after dosage reduction of 2% GCV eye drops.

目的:探讨使用低剂量更昔洛韦(GCV)滴眼液的患者巨细胞病毒(CMV)虹膜炎的复发率。方法:我们纳入了2023年1月至6月在东京大学医院使用2% GCV滴眼液治疗的休眠CMV虹膜炎患者,由于GCV供应不稳定,需要减少GCV滴眼液的剂量。如果患者患有活动性巨细胞病毒性视网膜炎并进行了角膜移植,则排除。我们检查了减少GCV滴眼液后巨细胞病毒性虹膜炎的复发情况。结果:纳入14例患者15只眼,平均年龄62.4±13.0岁。GCV滴眼液的频率从每天4次减少到13只眼睛的2次和2只眼睛的3次。GCV滴眼液减少后的平均观察时间为202.5±155.8 d。虽然在减少GCV滴眼液前6个月内没有复发,但减少GCV滴眼液后有5只眼(33.3%)复发。从GCV减少到复发的平均时间为59.2±11.3天。存活3个月无复发的患者以后无复发。结论:减少2% GCV滴眼液剂量后3个月内,三分之一的眼睛出现巨细胞病毒性虹膜炎复发。
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引用次数: 0
Half a Century's Quest for Seasonal Hyperacute Panuveitis (SHAPU): From Academic Curiosity to Public Health Concern. 半个世纪对季节性超急性全葡萄膜炎(SHAPU)的探索:从学术好奇到公共卫生关注。
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-13 DOI: 10.1080/09273948.2024.2444510
Yun Yao Goh, Ranju Kharel Sitaula, William Rojas-Carabali, Rupesh Agrawal, Pratap Karki, Haramaya Gurung, Eliya Shrestha, Pursottam Joshi, Anadi Khatri, Ananda Kumar Sharma, Sagun Narayan Joshi, Daya Ram Bhusal, Madan Prasad Upadhyay

For the past 50 years, significant progress has been made in understanding Seasonal Hyperacute Panuveitis (SHAPU), a mysterious blinding disease first reported in Nepal in 1975. Predominantly affecting Nepalese children, SHAPU occurs cyclically every odd year from September to December. While initially misclassified as endophthalmitis, SHAPU is set apart by its lack of trauma or surgery, failure to grow organisms in most intraocular fluid cultures, and its hallmark presentation of a "white pupil in red eye" with an association with moth exposure. Recent findings have expanded SHAPU's geographical scope beyond Nepal, with cases reported in Bhutan. Moreover, sporadic summer outbreaks have emerged, showing worse clinical outcomes than the typical cases. Recent studies suggest that the Gazalina moth may play a role, although the exact cause of SHAPU remains undetermined. Despite the increased understanding of SHAPU's geographic distribution and cyclical patterns, it is possible that some cases remain misdiagnosed or underreported. Continued research is critical to further exploring the aetiology of SHAPU, which will lead to better diagnostic tools, targeted treatments, and improved outcomes. The inclusion of SHAPU under more general categories such as endophthalmitis underscores the need for a clearer distinction of this condition to prevent blindness in at-risk populations.

在过去的50年里,在了解季节性超急性全葡萄膜炎(SHAPU)方面取得了重大进展,这是1975年在尼泊尔首次报道的一种神秘的致盲疾病。SHAPU主要影响尼泊尔儿童,每奇数年从9月到12月周期性发生一次。虽然最初被错误地归类为眼内炎,但SHAPU因其缺乏创伤或手术,在大多数眼内液培养物中不能生长生物体,以及其与飞蛾暴露有关的“红眼白色瞳孔”的标志性表现而与众不同。最近的调查结果将SHAPU的地理范围扩大到尼泊尔以外,在不丹报告了病例。此外,夏季还出现零星疫情,临床结果比典型病例差。最近的研究表明,尽管SHAPU的确切原因尚未确定,但Gazalina蛾可能起了一定作用。尽管对SHAPU的地理分布和周期性模式的了解有所增加,但仍可能有一些病例被误诊或漏报。持续的研究对于进一步探索SHAPU的病因至关重要,这将带来更好的诊断工具,有针对性的治疗和改善的结果。将SHAPU纳入更一般的类别,如眼内炎,强调需要更明确地区分这种情况,以防止高危人群失明。
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引用次数: 0
Demographic Features, Diagnoses and Real-World Clinical Management of Uveitis in Japan. 日本葡萄膜炎的人口学特征、诊断和临床治疗。
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-10 DOI: 10.1080/09273948.2024.2449179
Isami Hayashi, Hiroshi Keino, Makiko Nakayama, Yoshimasa Ando, Takayo Watanabe, Annabelle A Okada

Purpose: This study aimed to investigate demographic features, diagnoses of uveitis (intraocular inflammation), and real-world clinical practice in the use of local and systemic therapies for patients with uveitis in Tokyo, Japan.

Methods: Clinical records of 1,174 consecutive new patients (480 males, 694 females) referred to the Kyorin Eye Center, Kyorin University Hospital between January 2011 and December 2018 were retrospectively reviewed.

Results: Mean age at presentation was 52.6 years (range 4-94 years). By anatomic location, 439 patients (37.4%) had anterior uveitis, 18 (1.5%) had intermediate uveitis, 214 (18.2%) had posterior uveitis and 503 (42.8%) had panuveitis. The 3 most common diagnoses were sarcoidosis (9.1%), Vogt-Koyanagi-Harada (VKH) disease (8.3%), and acute anterior uveitis (5.7%). Compared to our previous study, rates of herpetic anterior uveitis and cytomegalovirus (CMV) retinitis increased while tuberculosis-related uveitis decreased. Unclassified uveitis remained the most common diagnosis (44.9%). Systemic corticosteroids and/or immunomodulatory agents were used in only 18.3% of patients. Immunomodulatory drugs including biologic agents were utilized in 4.9% of patients.

Conclusions: The most common uveitis anatomic type was panuveitis due mainly to high rates of sarcoidosis and VKH disease. Diagnoses of herpetic anterior uveitis and CMV retinitis increased, while tuberculosis-related uveitis decreased. Less than one-fifth of uveitis patients required systemic treatment.

目的:本研究旨在调查日本东京地区葡萄膜炎患者的人口统计学特征、葡萄膜炎(眼内炎症)的诊断以及使用局部和全身治疗的临床实践。方法:回顾性分析2011年1月至2018年12月在高丽大学医院高丽眼科中心连续就诊的1174例新患者(男性480例,女性694例)的临床记录。结果:平均发病年龄为52.6岁(范围4-94岁)。按解剖部位分,前葡萄膜炎439例(37.4%),中葡萄膜炎18例(1.5%),后葡萄膜炎214例(18.2%),全葡萄膜炎503例(42.8%)。最常见的3种诊断为结节病(9.1%)、Vogt-Koyanagi-Harada (VKH)病(8.3%)和急性前葡萄膜炎(5.7%)。与我们之前的研究相比,疱疹性前葡萄膜炎和巨细胞病毒(CMV)视网膜炎的发生率增加,而结核相关性葡萄膜炎的发生率下降。未分类葡萄膜炎仍然是最常见的诊断(44.9%)。只有18.3%的患者使用全身皮质类固醇和/或免疫调节剂。4.9%的患者使用包括生物制剂在内的免疫调节药物。结论:全葡萄膜炎是葡萄膜炎最常见的解剖类型,主要是结节病和VKH病的高发。疱疹性前葡萄膜炎和巨细胞病毒视网膜炎的诊断率上升,而结核相关性葡萄膜炎的诊断率下降。不到五分之一的葡萄膜炎患者需要全身治疗。
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引用次数: 0
Spectrum of Imaging Characteristics of Birdshot Chorioretinopathy. 鸟射型脉络膜视网膜病变的影像学特征。
IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-09 DOI: 10.1080/09273948.2024.2448529
Saleema Kherani, Akhila Alapati, Eirini Kaisari, Tedi Begaj, Timothy M Janetos, Anjum Koreishi, Debra A Goldstein

Birdshot chorioretinopathy (BSCR) is a bilateral, chronic posterior uveitis with characteristic clinical and imaging findings. Multimodal imaging including optical coherence tomography, fluorescein, and indocyanine green angiography is useful in diagnosis, as well as monitoring disease activity. Cystoid macular edema, choroidal thickening and infiltration, ellipsoid loss, and vasculitis are important imaging markers for disease activity. The purpose of this case series is to discuss the spectrum of disease presentations and highlight both common and atypical imaging characteristics of BSCR that may provide clinical insight to allow for better identification and treatment of disease.

鸟射性脉络膜视网膜病变(BSCR)是一种双侧慢性后葡萄膜炎,具有特征性的临床和影像学表现。包括光学相干断层扫描、荧光素和吲哚菁绿血管造影在内的多模态成像在诊断和监测疾病活动方面很有用。黄斑囊样水肿、脉络膜增厚浸润、椭球体丢失、血管炎是疾病活动性的重要影像学标志。本病例系列的目的是讨论疾病表现的范围,并强调BSCR的常见和非典型影像学特征,这些特征可能为更好地识别和治疗疾病提供临床见解。
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引用次数: 0
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