Prevalence and risk factors for complicated immuno-mediated uveitis: experience in a tertiary hospital

P. Luque-Linero , A. Espejo-González , N. Navarrete-Navarrete
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Abstract

Objective

To describe the characteristics of patients with uveitis and ocular complications in a tertiary hospital. As well as to determine the risk factors for the development of an ocular complication.

Methods

Retrospective study of patients with uveitis evaluated in a Uveitis Unit of the Virgen de las Nieves Hospital from January 2018 to October 2022. A descriptive and analytical study was carried out using logistic regression to know the predictive factors of a poor ocular prognosis.

Results

A total of 127 patients were studied, of which 63% were women and 83.5% were Caucasian. The median age was 51 years IQR (15–88) years. Following the SUN classification, uveitis was predominantly bilateral (55.1%) and anterior (52%), had a recurrent evolution in 51,2% and only 12,6% were granulomatous. Of the total uveitis, 74,2% of the sample turned out to have an immune-mediated profile, although a final diagnosis was only reached in 46,1% of the patients. A total of 17,3% patients suffer from loss of vision. Visual complications in decreasing order were: posterior synechiae (15,6%), cystic macular edema (14.8%), cataracts (13,1%), glaucoma (8,2%), epiretinal membranes (4,9%) and neovascular membranes (1,7%) and retinal detachment (4%). In the bivariate analysis, ethnicity other than Caucasian was significant, p = 0,024, and a number of outbreaks greater than 2, p = 0,045. The rest of the variables analyzed were not significant. In the multivariate analysis, they were significant outbreaks OR: 1,2 CI (1,051−1,426) and ethnicity OR: 0,11 CI (0,014−0,938).

Conclusions

The number of outbreaks and non-Caucasian race were related to a greater probability of presenting an ocular complication. An earlier and more specific diagnosis of the etiology, especially in these patients, would allow earlier treatment and improve their prognosis.
复杂免疫介导葡萄膜炎的发病率和风险因素:一家三级医院的经验。
目的描述一家三级医院中葡萄膜炎和眼部并发症患者的特征,并确定发生眼部并发症的风险因素。方法:对在圣母医院葡萄膜炎科接受评估的葡萄膜炎患者进行回顾性研究:对2018年1月至2022年10月期间在圣母医院葡萄膜炎科接受评估的葡萄膜炎患者进行回顾性研究。采用逻辑回归法进行描述性和分析性研究,以了解眼部不良预后的预测因素:共有 127 名患者接受了研究,其中 63% 为女性,83.5% 为白种人。中位年龄为 51 岁,IQR (15-88) 岁。根据SUN分类法,葡萄膜炎主要发生在双侧(55.1%)和前部(52%),51.2%的葡萄膜炎会反复发作,只有12.6%的葡萄膜炎是肉芽肿性的。在所有葡萄膜炎中,74.2%的样本具有免疫介导特征,但只有46.1%的患者得到了最终诊断。共有 17.3% 的患者视力下降。视力并发症依次递减为:后眼裂(15.6%)、囊性黄斑水肿(14.8%)、白内障(13.1%)、青光眼(8.2%)、视网膜外膜(4.9%)、新生血管膜(1.7%)和视网膜脱离(4%)。在双变量分析中,白种人以外的种族具有显著性(P = 0.024),爆发次数超过 2 次具有显著性(P = 0.045)。其余分析变量均不显著。在多变量分析中,疫情爆发 OR:1.2 CI(1.051-1.426)和种族 OR:0.11 CI(0.014-0.938)具有显著性:爆发次数和非高加索人种与出现眼部并发症的概率有关。对病因进行更早、更具体的诊断,尤其是对这些患者进行诊断,将有助于尽早治疗并改善预后。
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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