Análise retrospectiva e caracterização epidemiológica dos casos de uveíte em hospital terciário / Epidemiological analysis of cases of uveitis in a tertiary Hospital

Resumo Objetivo: Analisar a distribuição dos casos de uveíte em pacientes atendidos no Setor de Uveíte do Serviço de Oftalmologia do Hospital Federal Servidores do Estado do Rio de Janeiro. Métodos: Estudo epidemiológico retrospectivo, transversal e descritivo pela análise de prontuários de 63 pacientes atendidos no Serviço de Oftalmologia do Hospital Federal dos Servidores do Estado do Rio de Janeiro, no Setor de Uveíte, no período de Março a Outubro de 2016. Resultados: A média de idade foi de 45,54 (±15,8), sendo 50,8% do sexo feminino e 49,2% do masculino. Uveítes anteriores corresponderam à 63,49% dos casos, intermediárias 1,58% posterior 19,04% e panuveíte 15,87%. Apenas 33,3% dos pacientes encontravam-se com processo inflamatório ativo no momento da avaliação. Cerca de 74,6% das uveítes tinham causas não infecciosas e em 12,69% não foi possível a determinação etiológica. A causa isolada mais frequente foi Espondilite Anquilosante, responsável por 28,57% dos casos. Demonstrou-se que 55,5% dos pacientes tinham acometimento bilateral e 71,14% apresentavam uveíte não granulomatosa. Conclusões: Estudos epidemiológicos que tratam de uveíte são, em geral, realizados em centros terciários de atendimento, que por vezes apresentam perfil etiológico destas inflamações intra-oculares diferente da população geral.

Abstract Objective: To analyze the distribution of uveitis in patients at Uveitis Sector of Federal Hospital of Servants of Rio de Janeiro State. Methods: Retrospective epidemiological study of 63 appointments performed by ophthalmologist of Uveitis Sector at Federal Hospital of Servants of Rio De Janeiro State, between March and October of 2016. Results: The mean age was 45.54 (±15.8). 50.5% were female. Anterior uveitis corresponded to 63.49%. Only 33.3% of patient had an active inflammation at the moment of medical avaliation. 74.6% of uveitis had non-infeccious causes, and in 12.69% the etiology could not be determined. Ankylosing spondylitis was the most frequent cause, responsible for 28.57% of cases. 55.5% of patients had a bilateral uveitis, and 71.14% non-granulomatous uveitis. Conclusions: Epidemiological studies about uveitis are usually made in terciary hospitals, which do not reflect the epidemiological profile of population in general.

Estudo da prevalência das uveítes em hospital oftalmológico terciário em Teresina, Piauí, Brasil / Study of the prevalence of uveitis in a tertiary ophthalmology hospital in Teresina, Piauí, Brazil

RESUMO Objetivo: analisar a prevalência das uveítes em pacientes atendidos em um serviço oftalmológico terciário em Teresina, Piauí. Métodos: estudo retrospectivo baseado em prontuários de pacientes atendidos nesse serviço. Foram descritos: gênero, faixa etária, procedência, doença de base, diagnóstico anatômico, aspecto clínico e tempo de evolução. Resultados: foram incluídos 403 prontuários constatando-se que a cada 1000 pacientes atendidos neste serviço, 3,2 tinham uveíte.A idade média dos pacientes foi de 42 anos, tanto o gênero feminino (50,6%) quanto o gênero masculino (49,4%) foram acometidos similarmente, com 61,5% dos pacientes provenientes da capital. A doença de base mais frequente foi a toxoplasmose, seguida das uveítes idiopáticas apenas com manifestações oculares. Quanto à classificação anatômica, 49,6% foram posteriores e 3,5% foram intermediárias. Em relação ao aspecto clínico, 64% foram granulomatosas, 24,8% não-granulomatosas e 11,2% não foram classificáveis. Segundo a evolução clínica, 41,4% foram agudas, seguidas de 30,8% crônicas, 14,4% recorrentes e em 13,4% os pacientes não foi feito o acompanhamento. Conclusão: pudemos constatar que para cada 1000 pacientes atendidos neste serviço 3,2 tinham uveíte, apresentando-se a toxoplasmose como importante fonte de uveíte neste serviço.

ABSTRACT Objective: To analyze the prevalence of uveitis in patients treated at a tertiary ophthalmic service in Teresina, Piauí State, Brazil. Methods: This was a retrospective study based on medical records of patients treated at this service. Sex, age, origin, underlying diseases, anatomical diagnosis, clinical aspects and progression time were described. Results: 403 records were included, noting that 3.2 out of every 1,000 patients treated at the service had uveitis.The average age of patients was 42 years old, with both sexes (50.6% females and 49.4% males) affected similarly, and with 61.5% coming from the state capital, Teresina. The most common underlying disease was toxoplasmosis, followed by idiopathic uveitis with ocular manifestations only. As to the anatomical classification, 49.6% of them were posterior and only 3.5% were intermediate. Regarding the clinical aspects, 64% were granulomatous, 24.8% non-granulomatous, and 11.2% were not classifiable. According to the clinical progression, 41.4% were acute, followed by 30.8% chronic, 14.4% recurrent cases, and 13.4% of patients did not return for medical care. Conclusion: we found that for every 1,000 patients treated at the service, 3.2 had uveitis, with toxoplasmosis itself found to be an important source of uveitis.

Clinical characteristics of 1215 cases with uveitis / 中华眼底病杂志

Objective To analyze the clinical character of uveitis in second hospital ot Jilin university.Methods Retrospectively analyze the clinical data of uveitis patients referred to from Second Hospital of Jilin University from September 2009 to September 2014.According to anatomical location,the manifestation of these uveitis patients were divided into anterior uveitis,panuveitis,intermediate uveitis and posterior uveitis.To discuss the possible causes of these patients according to the general information and relevant clinical laboratory examinations results.Results There were 1215 cases in this study,which included 587 male,accounting for 48.31％;and 628 female,accounting for 51.69％.The ratio of male-tofemale was 0.93∶1.The range of the age of these patients was from 4 to 91 years old.The mean age of these patients at the onset of these disease was (41.43±14.20) years.Of the 1215 cases,40 male and 43 female were younger than 20 years.The ratio of male-to-female was 0.93∶ 1;412 male and 396 female were between 21 and 50 years old.The ratio of male-to-female was 1.04∶ 1;135 male 189 female were older than 50 years.The ratio of male-to-female was 0.71∶1.There were 572 cases of anterior uveitis,accounting for 47.08％;527 cases of panuveitis,accounting for 43.37％;52 cases of intermediate uveitis,accounting for 4.28％;64 cases of posterior uveitis,accounting for 5.27％.703 cases had etiological diagnosis according to the clinical character and the auxiliary results,accounting for 57.68％.Vogt-koyanagi Haradal (VKH) syndrome,ankylosing spondylitis associated with uveitis and Behcet' s disease were the common entity,accounting for 30.44％,19.77％ and 14.22％ respectively.Conclusions The mean age of these patients in this study was older,compared to other reports.Female patients were more than male,especially in these patients older than 50 years.VKH syndrome,ankylosing spondylitis associated with uveitis and Behcet's disease were the common entities.

Clinical and epidemiological characteristics of patients with uveitis in an emergency eye care center in Brazil / Características clínicas e epidemiológicas das uveítes em um serviço de urgência oftalmológica no Brasil

Purpose: To analyze the clinical and epidemiological characteristics of patients with uveitis in an emergency eye care center. Methods: We conducted a prospective, observational study of patients with active uveitis admitted between May 2012 and July 2012 to an emergency eye care center. Results: The majority of patients were male (63.2%), with a mean age of 43.2 years; 66.2% patients were of mixed ethnicity, 22.5% were Caucasian, and 11.3% were black. Anterior uveitis was observed in 70.1% patients, posterior uveitis in 26.5%, and panuveitis in 3.4%; no patient was diagnosed with intermediate uveitis. All patients had a sudden and acute presentation. The most frequent symptoms were ocular pain (76.9%), redness (59.8%), and visual blurring (46.2%). The majority of patients had unilateral disease (94.9%) with a mean symptom duration of 6.2 days. Diffuse and anterior uveitis were associated with ocular pain (p<0.001). Scotomata and floaters were more frequent in patients with posterior uveitis (p=0.003 and p=0.016, respectively). Patients with anterior uveitis presented with better visual acuity (p=0.025). Granulomatous keratotic precipitates were more frequent in patients with posterior uveitis (p=0.038). An etiological diagnosis based on the evaluation at the emergency center was made in 45 patients (38.5%). Conclusions: Acute anterior uveitis was the most frequent form of uveitis. Initial patient evaluation provided sufficient information for deciding primary therapy and aided in arriving at an etiological diagnosis in a considerable number of patients. .

Objetivo: Analisar as características clínicas e epidemiológicas das uveítes em um serviço de atendimento oftalmológico de urgência. Métodos: Estudo prospectivo, observacional de pacientes com uveíte ativa admitido entre maio e julho de 2012, em um serviço de atendimento oftalmológico de emergência. Resultados: A maioria dos pacientes eram do sexo masculino (63,2%) e a média de idade foi de 43,2 anos; 66,2% dos pacientes tinham etnia mista, 22,5% eram brancos e 11,3% negros. Uveíte anterior foi observada em 70,1% dos pacientes, uveíte posterior em 26,5%, e panuveíte em 3,4%, nenhum foi diagnosticado com uveíte intermediária. Todos os pacientes tiveram apresentação súbita e aguda. Os sintomas mais frequentes foram: dor ocular (76,9%), hiperemia conjuntival (59,8%) e baixa visual (46,2%). A maioria dos pacientes tinha doença unilateral (94,9%), com duração média dos sintomas de 6,2 dias. Uveítes anteriores e difusas foram associadas com dor ocular (p<0,001). Escotomas e a "floaters" foram mais frequentes na uveíte posterior (p=0,003 e p=0,016, respectivamente). Pacientes com uveíte anterior apresentaram melhor acuidade visual (p=0,025). Precipitados ceráticos granulomatosos foram mais frequentes em pacientes com uveíte posterior (p=0,038). Um diagnóstico etiológico com base na avaliação inicial no serviço de emergência foi possível em 45 pacientes (38,5%). Conclusão: A uveíte anterior aguda foi a uveíte mais frequentemente encontrada no serviço de urgência oftalmológica. A avaliação inicial do paciente forneceu informações suficientes para a conduta terapêutica primária, e possibilitou diagnóstico etiológico em um número considerável de pacientes. .

Studies on the etiologies and classification of uveitis / 中华眼底病杂志

Objective To study the clinical classification and etiologies of uveitis based on 1 214 uveitis patients reffered to Zhongshan Ophthalmic Center. Methods A retrospective analysis was made on the patients with uveitis, coming from all over China between January 1996 and December 2001. All kinds of uveitis were classified according to the anatomical criteria and etiological criteria. The relevant data of these patients, such as the age at uveitis onset and sex were also analyzed. Results The total number of the patients is 1 214 (male 698, female 516), with the average age at disease onset being 34.43. Anterior uveitis, the most common type, was seen in 546 cases, accounting for 44.98% of all the patients, followed in descending order by panuveitis (530 cases, 43.66%), intermediate uveitis(78 cases, 6.43%) and posterior uveitis(60 cases, 4.94%). Etiological factors and clinical entities were identified in 703 patients, accounting for 57.91% of all the patients, and the other 511 patients were idiopathic ones. The most common types of anterior uveitis were idiopathic uveitis(316 cases, 57.88%), followed by Fuchs syndrome(85 cases) and ankylosing spondylitis(45 cases). Behcet ) disease(218 cases, 41.13%) and Vogt-Koyanagi-Harada syndrome(196 cases, 36.98%) were the most common entities in panuveitis. Neither etiological factors nor clinical entities could be identified in the patients with intermediate uveitis and those with posterior uveitis. Conclusions Uveitis occurs mostly in young and middle-aged adults. In general, a predilection was seen in the male as compared with the female in the development of uveitis. Idiopathic anterior uveitis, Behcet ) disease and Vogt-Koyanagi-Harada syndrome are the most common entities of uveitis seen in China. Classification based on etiological and anatomical factors may provide a reasonable system for the study of uveitis.