Uveitis and Scleritis as a Risk Factor for Mortality.
| Autor: | Lim JZ; Department of Ophthalmology, Te Whatu Ora Auckland/Health, Auckland, New Zealand.; Department of Ophthalmology, University of Auckland, Auckland, New Zealand., Samalia PD; Department of Ophthalmology, Te Whatu Ora Southern/Health New Zealand Southern, Dunedin, New Zealand.; Department of Ophthalmology, University of Otago, Dunedin, New Zealand., Sims JL; Department of Ophthalmology, Te Whatu Ora Auckland/Health, Auckland, New Zealand., Niederer RL; Department of Ophthalmology, Te Whatu Ora Auckland/Health, Auckland, New Zealand.; Department of Ophthalmology, University of Auckland, Auckland, New Zealand. |
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| Jazyk: | angličtina |
| Zdroj: | Ocular immunology and inflammation [Ocul Immunol Inflamm] 2024 Nov; Vol. 32 (9), pp. 1929-1936. Date of Electronic Publication: 2024 Jan 10. |
| DOI: | 10.1080/09273948.2023.2296033 |
| Abstrakt: | Purpose: Uveitis and scleritis may be caused by local or systemic infection, or associated with noninfectious systemic inflammatory autoimmune disease. This study explored the all-cause mortality following an individual's first presentation with uveitis/scleritis. Methods: A cross-sectional study was conducted on all uveitis/scleritis patients diagnosed by uveitis specialists and treated in a single tertiary referral center in New Zealand between 2006 and 2020(15y). Masquerade syndromes including intraocular lymphoma were excluded. Outcome measures: demographics, etiology of uveitis/scleritis, anatomical location and all-cause mortality. Results: 2723 subjects were identified. Median age of onset of uveitis/scleritis was 44.9 years (Range:1.5-99.5 years). 49.6% were female. Median follow-up from diagnosis of uveitis/scleritis was 8.0 years (IQR 4.1-11.6 years) with a total follow-up of 24 443.3 subject-years. The most frequent diagnosis was idiopathic disease (30.9%), HLA-B27-positive uveitis (20.0%), and sarcoidosis (4.7%). Infectious etiologies (24.1%) were most commonly from herpes zoster virus (9.3%) and toxoplasmosis (4.3%). The age-adjusted mortality rate was higher in subjects with idiopathic disease, sarcoidosis, Fuchs' uveitis syndrome, granulomatosis with polyangiitis/ANCA-associated vasculitis, toxoplasmosis, and herpes zoster virus, when compared to HLA-B27-positive uveitis. Hazard of mortality peaked in the first seven years following diagnosis, then subsequently declined. Patients with uveitis/scleritis had a significantly higher rate of mortality compared to the general New Zealand population (IRR 1.656 p = 0.017). Conclusion: Infectious etiologies of uveitis/scleritis in this cohort were high when compared to other developed nations, attributable to data from a tertiary referral center treating inpatients. Potential shared inflammatory mechanisms in the eye and other organs can lead to concurrent non-ocular disease requiring systemic treatment, impacting an individual's longevity. |
| Databáze: | MEDLINE |
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