Prognostic Factors in Syphilitic Uveitis
| Autor: | David Lebeaux, Sawsen Salah, Emmanuel Héron, Paul Loubet, Marie-Hélène Errera, Florence Hoogewoud, L. Frumholtz, Matthieu Groh, Odile Launay, Dominique Monnet, José-Alain Sahel, Olivier Lortholary, Caroline Charlier, Neila Sedira, Laetitia Coutte, C. Vanhaecke, Claire Le Jeunne, Nadjet Benhaddou, Nicolas Dupin, Antoine P. Brézin, Philippe Blanche |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Sexually transmitted disease medicine.medical_specialty Visual acuity Visual Acuity Sulfadiazine Azithromycin Polymerase Chain Reaction Gastroenterology Eye Infections Bacterial Uveitis 03 medical and health sciences 0302 clinical medicine Internal medicine HIV Seropositivity medicine Humans Syphilis 030212 general & internal medicine Retrospective Studies business.industry Panuveitis Retrospective cohort study Middle Aged Eye infection Fluorescent Treponemal Antibody-Absorption Test Prognosis medicine.disease Anti-Bacterial Agents Syphilis Serodiagnosis Surgery Ophthalmology Methylprednisolone Doxycycline Relative risk Penicillin G Benzathine 030221 ophthalmology & optometry Female medicine.symptom business Follow-Up Studies medicine.drug |
| Zdroj: | Ophthalmology. 124:1808-1816 |
| ISSN: | 0161-6420 |
| Popis: | Purpose To identify predictors of treatment success in syphilitic uveitis (SU). Design Retrospective multicentric analysis of patients treated for SU. Participants A total of 95 eyes (66 patients, mean [standard deviation] aged 49 [12.5] years, 31 [47%] of whom were human immunodeficiency virus [HIV]+) were analyzed. Methods Activity of SU was assessed at 1 week and 1 month after treatment onset, and at last follow-up. Improvement was defined by a ≥2-step decrease of both anterior chamber and vitreous haze inflammation levels, and by the size reduction in chorioretinal lesions. Main Outcome Measures Recovery was defined as the resolution of inflammation in all anatomic structures at 1 month. Results Panuveitis and posterior uveitis were the most frequent findings. Inflammatory parameters were higher in HIV+ patients. Recovery was reported in 65% and 85% of eyes at 1 month and at last follow-up, respectively. In multivariate analysis, after adjusting for initial best-corrected visual acuity and the antimicrobial treatment regimen, clinical improvement at 1 week (corrected risk ratios [cRR], 3.5 [2.3–3.8]; P = 0.001) was predictive of recovery at 1 month, whereas the use of periocular dexamethasone injections (cRR, 0.05 [0.02–0.6]; P = 0.01) and methylprednisolone pulses negatively affected the outcomes of eyes. Conclusions Early improvement is the strongest predictor of ophthalmological recovery in SU. |
| Databáze: | OpenAIRE |
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