A decade-long review: insights into diagnosis and disease evolution of uveitis from a single-center study.

IF 2.8 3区医学 Q1 OPHTHALMOLOGY

Eye Pub Date : 2025-04-05 DOI:10.1038/s41433-025-03772-8

Gunjan Sharma, Atul Arora, William Rojas-Carabali, Bernett Lee, Amod Gupta, Reema Bansal, Mohit Dogra, Deeksha Katoch, Aman Sharma, Ankur Jindal, Deepti Suri, Surjit Singh, Rupesh Agrawal, Vishali Gupta

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引用次数: 0

Abstract

Purpose: To analyse the evolution of uveitis diagnosis over a 10-year period, emphasizing the change in etiological diagnosis, and the factors associated with recurrences.

Design: Retrospective chart review.

Methods: A total of 15,000 patients with uveitis presented at our tertiary care institute in North India between 1992 and 2023. Of these,123 patients completed 10-year follow-up and were included in the study. The data of patients was collected on an offline purpose-built uveitis registry portal: Ocular Autoimmune Systemic Inflammatory and Infectious Study(OASIS).

Results: The study included 123 patients (48.78% males; mean age: 29.11 ± 15.22 years). The most common anatomical and etiological diagnosis at presentation were anterior (49/123,34.96%) and idiopathic(59/123,47.97%) uveitis respectively. At the end of 10 years, anterior uveitis remained the most common anatomical diagnosis (43/123,39.83%) while the most common etiological diagnosis was immune-mediated uveitis (50/123,40.65%). An etiological diagnosis could be established in 50.85% (30/59) of patients initially labelled as idiopathic. Tuberculous uveitis (39/44, 88.63%) and Juvenile Idiopathic Arthritis associated uveitis (16/49, 32.65%) were the commonest infectious and immune-mediated aetiologies at the 10-year follow-up. Ninety-six (80.67%) patients experienced multiple episodes of ocular inflammation with a mean recurrence rate of 0.386 ± 0.24 recurrences/year. Anterior uveitis (p = 0.01), the change in etiological diagnosis after the first year (p = 0.03), positive HLA-B27 at baseline (p = 0.04), and the diagnosis of a systemic disease prior to the onset of uveitis were associated with higher recurrences rates (p = 0.03).

Conclusion: Over 10-year of follow-up, half of the uveitis diagnoses evolved from idiopathic to specific infectious or immune-mediated aetiologies. Our results indicate that patients with a high recurrence rate may benefit from re-evaluation to find the definitive cause of uveitis.

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一项长达十年的回顾：单中心研究对葡萄膜炎诊断和疾病演变的见解

目的：分析近10年来葡萄膜炎诊断的演变，强调病因诊断的变化，以及与复发相关的因素。设计：回顾性图表回顾。方法：1992年至2023年间，在我们位于印度北部的三级保健研究所共有15,000名葡萄膜炎患者。其中123名患者完成了10年随访并纳入研究。患者的数据是在一个线下专门建立的葡萄膜炎登记门户网站上收集的：眼部自身免疫系统炎症和感染研究（OASIS）。结果：纳入123例患者，其中男性48.78%；平均年龄：29.11±15.22岁)。最常见的解剖和病因诊断分别为前路（49/123,34.96%）和特发性（59/123,47.97%）葡萄膜炎。10年后，最常见的解剖诊断为前葡萄膜炎（43/123,39.83%），最常见的病因诊断为免疫介导性葡萄膜炎（50/123,40.65%）。50.85%（30/59）最初标记为特发性的患者可以确定病因学诊断。在10年随访中，结核性葡萄膜炎（39/44,88.63%）和幼年特发性关节炎相关性葡萄膜炎（16/49,32.65%）是最常见的感染和免疫介导的病因。96例（80.67%）患者出现多次眼部炎症，平均复发率为0.386±0.24次/年。前葡萄膜炎（p = 0.01）、一年后病因诊断的变化（p = 0.03）、基线时HLA-B27阳性（p = 0.04）以及发生葡萄膜炎前的全身性疾病诊断与较高的复发率相关（p = 0.03）。结论：在超过10年的随访中，一半的葡萄膜炎诊断从特发性发展到特异性感染或免疫介导的病因。我们的结果表明，复发率高的患者可能会受益于重新评估，以找到葡萄膜炎的确切原因。

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

Eye 医学-眼科学

CiteScore

6.40

自引率

5.10%

发文量

481

审稿时长

3-6 weeks

期刊介绍： Eye seeks to provide the international practising ophthalmologist with high quality articles, of academic rigour, on the latest global clinical and laboratory based research. Its core aim is to advance the science and practice of ophthalmology with the latest clinical- and scientific-based research. Whilst principally aimed at the practising clinician, the journal contains material of interest to a wider readership including optometrists, orthoptists, other health care professionals and research workers in all aspects of the field of visual science worldwide. Eye is the official journal of The Royal College of Ophthalmologists. Eye encourages the submission of original articles covering all aspects of ophthalmology including: external eye disease; oculo-plastic surgery; orbital and lacrimal disease; ocular surface and corneal disorders; paediatric ophthalmology and strabismus; glaucoma; medical and surgical retina; neuro-ophthalmology; cataract and refractive surgery; ocular oncology; ophthalmic pathology; ophthalmic genetics.