与眼弓形虫病并发症和视觉不良后果相关的临床特征：对853名患者的分析：眼弓形体病的并发症和视觉效果。

IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-02-25 DOI:10.1016/j.ajo.2025.02.027

Alejandra de-la-Torre , Germán Mejía-Salgado , Carlos Cifuentes-González , Miguel Cuevas , Sandra García , Carlos M. Rangel , Claudia Durán , Diana Isabel Pachón-Suárez , Andrés Bustamante-Arias , William Rojas-Carabali

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引用次数: 0

摘要

目的：描述哥伦比亚眼部弓形虫病（OT）的临床特征，并确定与眼部并发症和视力不良相关的因素。设计：多中心横断面研究。方法：收集哥伦比亚7家眼科中心OT患者的人口统计学和临床特征，包括病程、葡萄膜炎部位（根据葡萄膜炎命名标准）、炎症类型（推测为肉芽肿性与非肉芽肿性）、眼部并发症（白内障、青光眼、黄斑水肿、视网膜脱离、玻璃体出血、视网膜前膜、带性角膜病变）和视力结果。亚组分析包括记录病变特征的患者。经年龄和性别调整后的Logistic回归评估了眼部并发症（上述任何一种并发症）、中重度视力障碍（视力较好的眼睛BCVA 20/400）和失明（视力较好的眼睛BCVA≤20/400）相关的因素。结果：共纳入OT患者853例，其中女性431例，男性422例，平均年龄38±17.9岁。OT主要表现为急性（57%）、单侧（79%）和非肉芽肿性葡萄膜炎（78%）。60%（512例）患者最终BCVA评分为20/60。与眼部并发症相关的因素包括：年龄：50岁(OR=4.75；p50 (OR = 1.74;p=0.001)，双侧受累(OR=1.53；p=0.017)， 1区病变(OR=8.25；p = 0.015)。结论：与其他地区相比，哥伦比亚的OT效果较差。极端年龄、双侧受累、视网膜脉络膜炎合并玻璃体炎/AC炎症和1区病变是并发症和视力差的主要危险因素。

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Clinical Characteristics Associated With Complications and Poor Visual Outcomes in Ocular Toxoplasmosis: Analysis of 853 Patients

PURPOSE

To describe the clinical characteristics of ocular toxoplasmosis (OT) in Colombia and identify factors associated with ocular complications and poor visual outcomes.

DESIGN

Multicenter cross-sectional study.

METHODS

Demographic and clinical characteristics—including disease course, uveitis location (according to the Standardization of Uveitis Nomenclature), type of inflammation (presumed granulomatous vs nongranulomatous), ocular complications (cataract, glaucoma, macular edema, retinal detachment, vitreous hemorrhage, epiretinal membrane, and band keratopathy), and visual outcomes—were collected from patients with OT across seven ophthalmological centers in Colombia. A subgroup analysis included patients with documented lesion characteristics. Logistic regression, adjusted for age and sex, assessed factors associated with ocular complications (any of the complications above), moderate-to-severe vision impairment (BCVA <20/60 to >20/400 in the better-seeing eye), and blindness (BCVA ≤20/400 in the better-seeing eye).

RESULTS

853 OT patients (431 females, 422 males) were included, with a mean age of 38 ± 17.9 years. OT predominantly manifested as acute (57%), unilateral (79%), and nongranulomatous uveitis (78%). Sixty percent (512) had a final BCVA >20/60. Factors associated with ocular complications included age >50 (OR = 4.75; P < .001), retinochoroiditis with vitritis/AC inflammation (OR = 2.85; P < .001), presumed granulomatous uveitis (OR = 2.04; P < .001), persistent disease or early recurrences (sooner than 3 months) (OR = 3.24; P < .001), and recurrences first occurring after 3 months (OR = 1.79; P = .009). Blindness was linked to age <16 (OR = 1.94; P = .025), >50 (OR = 1.74; P = .001), bilateral involvement (OR = 1.53; P = .017), and zone 1 lesions (OR = 8.25; P = .015).

CONCLUSION

OT in Colombia shows worse outcomes compared to other regions. Extreme ages, bilateral involvement, retinochoroiditis with vitritis/AC inflammation, and zone 1 lesions are major risk factors for complications and poor visual outcomes.

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.