Characteristics, evolution, and outcome of patients with non-infectious uveitis referred for rheumatologic assessment an
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ORIGINAL ARTICLE
Characteristics, evolution, and outcome of patients with non-infectious uveitis referred for rheumatologic assessment and management: an Egyptian multicenter retrospective study Waleed A. Hassan 1 & Basma M. Medhat 2 & Maha M. Youssef 3 & Yomna Farag 4 & Noha Mostafa 4 Alshaimaa R. Alnaggar 5 & Mervat E. Behiry 5,6 & Rasha A. Abdel Noor 7 & Riham S. H. M Allam 3
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Received: 29 April 2020 / Revised: 13 August 2020 / Accepted: 20 August 2020 # International League of Associations for Rheumatology (ILAR) 2020
Abstract Objective To investigate the characteristics, evolution, and visual outcome of non-infectious uveitis. Methodology Records of 201 patients with non-infectious uveitis (136 (67.7%) males and 84 (41.8%) juvenile-onset (≤ 16 years)) were retrospectively reviewed. Data were analyzed through Kruskal–Wallis and Mann–Whitney, chi-square (χ2) tests, and logistic regression. Results The median disease and follow-up durations were 36 (interquartile range (IQR) 24–70) and 24 (IQR 10–36) months, respectively. Fifty-eight (28.9%) patients had persistently idiopathic uveitis, and 143 (71.1%) were associated with rheumatic diseases, of whom uveitis heralded, coincided with, and succeeded the rheumatic manifestation(s) in 62/143 (43.4%), 37/143 (25.9%), and 44/143 (30.7%) patients, respectively. Established rheumatic diseases were Behçet’s disease (103/201 (51.2%)), juvenile idiopathic arthritis (13/201 (6.5%)), sarcoidosis (8/201 (4%)), seronegative spondyloarthropathy (7/201 (3.5%)), and Vogt-Koyanagi-Harada (7/201 (3.5%)), and other diagnoses were present in 5/201 (2.5%) patients. Patients with idiopathic uveitis were characterized by a juvenile-onset (p < 0.001), lower male predominance (p = 0.01), prevalent granulomatous (p < 0.001), and anterior (p = 0.001) uveitis. The median visual acuity at last visit was 0.3 (IQR 0.05–0.6). Visual loss was present in 45/201 (22.3%) patients (36/201 (17.9%) unilateral and 9/201 (4.4%) bilateral). Apart from a longer disease duration (p = 0.002), lower educational level (p = 0.03), and prevalent panuveitis (p < 0.001), visual loss was not associated with any other studied ocular or extra-ocular characteristics. Conclusion Behçet’s disease (51.2%) and idiopathic uveitis (28.9%) were the most prevalent causes of non-infectious uveitis in our study. Visual loss (22.3%) was associated with a longer disease duration, lower education level, and prevalent panuveitis. Key Points • Most common causes of uveitis referred to rheumatologists were Behçet’s disease and idiopathic uveitis. • Several rheumatic diseases initially presented only with uveitis, more commonly in adult and male patients. • Panuveitis was more frequent among patients with an established rheumatic disease, whereas granulomatous uveitis was uncommon. • Longer disease duration and presence of panuveitis were independently associated with visual loss.
Keywords Behçet’s disease . Idiopathic uveitis . Juvenile . Non-infectious uveitis . Outcome . Uveitis
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