When and which second-line workup to perform for uveitis: a tertiary care center experience.

IF 3.3 4区 医学 Q1 OPHTHALMOLOGY
Gaétan Bana, Kaine Angioi-Duprez, Jean-Baptiste Conart, Thomas Moulinet
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Abstract

Objective: Uveitis are inflammatory disorders of various etiologies. The first-line etiological workup is currently poorly codified, and some patients undergo sequential investigations. However, what leads the clinician to perform subsequent exams and the relevance of such exams remain to be determined. The main objective of the study was to evaluate the relevance and modalities of a second-line workup of patients with uveitis.

Materials and methods: We performed a monocentric retrospective study in Nancy University Hospital. All adult patients who underwent an etiological workup in the Internal Medicine Department between January 2014 and December 2021 were included.

Results: Among the 247 patients included, 52 underwent a second-line workup, resulting in a modified diagnosis for 18 of them (34.6%), mainly sarcoidosis, intraocular lymphoma, and Crohn's disease. On multivariate analysis, a follow-up longer than 40 months and idiopathic uveitis were associated with the realization of a second-line workup (OR = 2.97 [1.58 - 5.61]; p = 0.001, and OR = 6.13 [2.3-16.1]; p < 0.01, respectively). The presence of synechia and ocular granuloma were associated with a modification of the diagnosis (OR = 8.03 [1.85-45.48]; p = 0.01, and OR = 5.14 [1.22-24.78]; p = 0.03, respectively).

Conclusion: The second-line workup is relevant in up to one-third of patients, mainly if presenting with a modification of ophthalmological examination, synechiae, and a granulomatous feature, and should focus on intraocular lymphoma, sarcoidosis, and Crohn's disease. Larger studies are needed to provide guidelines for second-line workup.

葡萄膜炎何时进行二线检查以及进行哪种检查--三级医疗中心的经验。
目的:葡萄膜炎是由各种病因引起的炎症性疾病。目前,一线病因检查的规范性还很差,有些患者需要进行连续检查。然而,是什么导致临床医生进行后续检查以及这些检查的相关性仍有待确定。本研究的主要目的是评估葡萄膜炎患者二线检查的相关性和方式:我们在南锡大学医院进行了一项单中心回顾性研究。研究对象包括2014年1月至2021年12月期间在内科接受病因检查的所有成年患者:结果:在纳入的 247 名患者中,52 人接受了二线检查,其中 18 人(34.6%)的诊断有所改变,主要是肉样瘤病、眼内淋巴瘤和克罗恩病。多变量分析显示,随访时间超过 40 个月和特发性葡萄膜炎与二线检查的实现有关(OR = 2.97 [1.58 - 5.61]; p = 0.001,OR = 6.13 [2.3-16.1]; p < 0.01)。合眼和眼肉芽肿的存在与诊断的改变有关(OR = 8.03 [1.85-45.48];p = 0.01 和 OR = 5.14 [1.22-24.78];p = 0.03):多达三分之一的患者需要进行二线检查,主要是在出现眼科检查改变、眼裂和肉芽肿特征时,应重点检查眼内淋巴瘤、肉样瘤病和克罗恩病。需要进行更大规模的研究,为二线检查提供指导。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.20
自引率
4.80%
发文量
223
审稿时长
38 days
期刊介绍: Official journal of the Canadian Ophthalmological Society. The Canadian Journal of Ophthalmology (CJO) is the official journal of the Canadian Ophthalmological Society and is committed to timely publication of original, peer-reviewed ophthalmology and vision science articles.
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