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.

Patterns of uveitis in the Middle East and Europe

To compare the patterns of uveitis, emphasizing similarities and discrepancies, in the Middle East and Europe. Six articles reporting uveitis patterns from the Middle East including a total of 2, 693 cases, and seven articles with a sum of 4, 379 cases from Europe were analyzed and patterns in each region were defined and compared. In both regions, uveitis was most commonly seen in the fourth decade of life with anterior uveitis being the most common anatomical form. Idiopathic cases accounted for the majority of anterior and intermediate uveitis; toxoplasmosis was the most frequent entity in posterior uveitis while Behcet's disease and idiopathic forms were the next most common causes in the Middle East and in Europe, respectively. Since patterns of uveitis differ in various geographic regions, discovering these patterns would be helpful for the diagnosis and treatment of this broad category of conditions. This necessitates applying a universal diagnostic classification system to enable accurate comparisons

Pattern of uveitis in North East India: a tertiary eye care center study.

We conducted an institutional-based retrospective study on 308 uveitic patients and analyzed the pattern of uveitis in Northeastern India. Anterior uveitis was the most common type (47.07%) followed by posterior (29.87%), intermediate (12.98%) and panuveitis (10.06%). Toxoplasmosis (40.21%) had the highest incidence among posterior uveitis cases. Harada's form of Vogt Koyanagi Harada's disease is a frequent occurrence in this subset of the population.

Pattern of uveitis in a referral eye clinic in north India.

PURPOSE: To report the pattern of uveitis in a north Indian tertiary eye center. METHODS: A retrospective study was done to identify the pattern of uveitis in a uveitis clinic population of a major referral center in north India from January 1996 to June 2001. A standard clinical protocol, the "naming and meshing" approach with tailored laboratory investigations, was used for the final diagnosis. RESULTS: 1233 patients were included in the study; 641 (51.98%) were males and 592 (48.01%) females ranging in age from 1.5 to 75 years. The anterior uveitis was seen in 607 patients (49.23%) followed by posterior uveitis (247 patients, 20.23 %), intermediate uveitis (198 patients, 16.06%) and panuveitis (181 patients, 14.68%). A specific diagnosis could be established in 602 patients (48.82%). The infective aetiology was seen in 179 patients, of which tuberculosis was the commonest cause in 125 patients followed by toxoplasmosis (21 patients, 11.7%). Non-infectious aetiology was seen in 423 patients, of which ankylosing spondylitis was the commonest cause in 80 patients followed by sepigionous choroidopathy (62 patients, 14.65%). CONCLUSION: Tuberculosis and toxoplasmosis were the commonest form of infective uveitis, while ankylosing spondylitis and serpiginous choroidopathy were commonly seen as the non-infective causes of uveitis in North India.

Patterns of uveitis in children presenting at a tertiary eye care centre in south India.

PURPOSE: To study the patterns of uveitis in the paediatric age group in a referral eye care centre in south India. MATERIALS AND METHODS: Thirty-one patients 15 years or younger with uveitis, examined in the year 2000, were included in this study. The uveitis was classified according to the anatomical site of ocular involvement and the most probable aetiological factor. The final diagnosis was based on clinical manifestations and results of specific laboratory investigations. RESULTS: A total 31 (6.29%) paediatric uveitis cases were seen among the 493 uveitic cases in the year 2000. The male:female ratio was 17:14. Anterior (9 cases), intermediate (9 cases) and posterior uveitis (9 cases) were seen in equal number. Four patients had panuveitis. Twenty-seven patients had visual acuity of 6/36 or better at presentation. Approximately 25% (8 of 31) patients had cataract secondary to inflammation. Immunosuppressives were administered in 4 patients and one patient required cataract surgery. CONCLUSION: Uveitis in children comprises approximately 6% of uveitis cases in a referral practice in south India. Anterior, intermediate and posterior uveitis are seen in equal numbers. We recommend that intermediate uveitis be ruled out in all cases of anterior uveitis by careful clinical evaluation including examination under anesthesia (EUA) when required.

Uveítes anteriores associadas a doenças sistêmicas / Anterior uveitis associated to systemic diseases

As uveítes anteriores são caracterizadas pela inflamação preponderante do segmento anterior do olho. Hiperemia conjuntival, reação de câmara anterior com células e "flare", precipitados ceráticos e sinéquias posteriores são sinais que compõem o quadro inflamatório. Aspectos clínicos de algumas doenças sistêmicas envolvidas na etiologia das uveítes anteriores serão abordados neste artigo.

Ocorrência de uveítes no estado de Pernambuco / Occurency of uveitis in Pernambuco state, Brazil

Com o objetivo de se determinar a frequência dos diferentes tipos de uveíte e suas etiologias em centro de referência de enfermidades oculares no estado de Pernambuco, foi realizado estudo transversal em 197 pacientes com diagnóstico de uveíte atendidos no ambulatório especializado da Fundação Altino Ventura. Noventa e nove pacientes (50,3 por cento) eram do sexo feminino, sendo de 32,1 anos a média de idade (s=15,8 anos). Cinquenta e dois por cento (102 pacientes) tiveram uveítes posteriores, 26,0 por cento, uveíte anterior, 21,0 por cento, difusa e 0,5 por cento, intermadiária. A etiologia foi determinada em 54,0 por cento dos casos e 90 pacientes (46,0 por cento) foram considerados casos idiopáticos. A toxoplasmose foi a etiologia mais frequente (34,0 por cento), seguida de neurorretinite unilateral subaguda difusa (3,6 por cento) e Vogt-Koyanagi-Harada (3,6 por cento). De um modo geral, as uveítes ocorreram mais em indivíduos entre 11 e 40 anos, sem predileção por sexo. O acometimento foi mais frequente na região posterior do globo ocular, sendo toxoplasmose a etiologia mais encontrada, concordando com a literatura nacional. Quase metade da amostra (46,0 por cento) não teve etiologia definida

La uveítis como expresión de un modelo clínico / Uveitis as an expression of a clinical model

En 196 pacientes con uveítis, 126 mujeres (64,3%) y 70 hombres (35,7%), siguiendo la clasificación recomendada por el Grupo Internacional de Uveítis (IUSG), encontramos la siguiente distribución: 1. Anteriores en 86 (43,9%); 2. Difusas en 59 (30,1%); 3. Posteriores en 38 (19,4%), y 4. Intermedias en 13 (6,6%). El promedio de edad fue de 38,5 años (2-74): para las anteriores de 42,6 años, para las difusas de 37,2 años, para las posteriores de 35,9 años y para las intermedias de 24,8 años. Encontramos la causa en 101 (51,5%), no incluyendo en éstas a 29 (14,8%) presuntos, los que están entre las de causa desconocida. La uveítis anteriores mostraron causa desconocida en 59 casos, 30,1% del total de pacientes, en tanto que las causas fueron mejor precisadas en las posteriores con 30 casos (15,3%) del total). Entre las causas más frecuentemente conocidas podemos destacar: en las anteriores, a las enfermedades reumáticas, a los virus (herpes simple y zoster) y a la uveítis heterocrómica de Fuchs; en las difusas, al síndrome de Vogt-Koyanagi-Harada y al síndrome de Behcet; en las posteriores, principalmente a la toxoplasmosis, luego la tuberculosis y la toxocariasis. Las uveítis intermedias no mostraron otra causa, pero las incluimos entre las de causa determinadas. El 10% de todos los casos fueron toxoplasmosis

Clinical analysis of uveitis

Uveitis can be classified in a variety of ways and this fact makes it difficult to compare results. Therefore we classified uveitis by the location with the method of Henderly; anterior-, posterior-, intermediate- and panuveitis. We determined the frequency of occurrence, etiology and clinical characteristics of various forms of uveitis. We conducted a retrospective analysis of 683 patients with uveitis seen at Seoul National University Hospital from January 1978, to December 1987. The results were as follows. 1. 192 cases (28.1%) occurred as anterior uveitis, 218 cases (31.9%) as posterior uveitis, 166 cases (24.3%) as panuveitis and 107 cases (15.7%) as pars planitis. Posterior uveitis was the most common form of uveitis. 2. In cases of anterior uveitis, 142 cases (74.0%) were idiopathic, traumatic uveitis was seen in 18 cases. In posterior-uveitis, 111 cases (50.9%) were idiopathic, retinal vasculitis including Eales' disease in 60 cases (27.5%), toxoplasmosis in 23 cases (10.6%). In cases of panuveitis, idiopathic form occurred in 80 cases (48.2%), Behcet's disease in 41 cases (24.7%). The idiopathic form was the most common entity in all locations of uveitis.