| Objective:Uveitis is a leading form of inflammatory eye disease,and there are few national epidemiological studies so far.Several investigations from eye centres in our country have reported the clinical characteristics of uveitis in their areas,while the data of uveitis in Shanxi province is unknown.We aimed to study the clinical characteristics of 587 patients with uveitis admitted to the Shanxi Eye hospitial from2016 to 2020,and analyse the clinical characteristics and epidemiology of uveitis patients in Shanxi province.It has been reported that the main cause of vision loss in uveitis is inflammatory injury and complications,and uveitic cataract is the most common complication.Based on propensity score matching method,we evaluate the efficacy and safety of phacoemulsification with intravitreal injection of 3 mg triamcinolone acetonide in preventing postoperative inflammation and complications of uveitis complicated cataract in the real world.Methods:1.We retrospectively reviewed 587 patients with endogenous uveitis who were admitted to the Shanxi Eye hospital from January 2016 to December 2020,and investigaed data on gender,onset age,primary cause,onset month,anatomical classification,visual acuity and complications.2.Literatures with regional representativeness,relatively recent reporting time were selected in Medline database.We have summarized the characteristics of uveitis and the proportion of different type of uveitis,and then compared our results with those studies from different regions.3.Patients with non-infectious uveitis complicated cataract who were subjected to phacoemulsification in Shanxi Eye Hospital from January 2016 to December2020 were enrolled in this study.The patients in IVTA group and control group were preliminarily determined according to whether they were combined with intravitreal 3 mg triamcinolone acetonide(TA)injection after phacoemulsification.The patients in the two groups were finally enrolled in two groups after propensity score matching.4.Patients were followed at least till 3 months.Outcome measures were best corrected visual acuity(BCVA),anterior chamber inflammation,intraocular pressure,corneal endothelial cell density,central macular thickness and complications within 3 months follow-up between the two groups postoperatively.Results:1.587 uveitis patients in our study were enrolled,and male–female ratio was 1.03.The average onset age was 38.7±14.7 years.By anatomical classification,panuveitis was the most common(316 cases,53.8%),followed by anterior uveitis(231 cases,39.4%),posterior uveitis(37 cases,6.3%)and intermediate uveitis(3 cases,0.5%).Among panuveitis cases,Vogt-Koyanagi-Harada syndrome(114 cases,36.08%)and Behcet’s disease(38 cases,12.03%)were the most common.Among anterior uveitis cases,HLA-B27-associated uveitis(46cases,19.91%)and Fuchs syndrome(39 cases,16.88%)were the most common uveitis entities.The incidence ratio of acute retinal necrosis syndrome(ARN)was 4.94%,which was in third place of all uveitis with known etiology in our center.2.The prevalence of uveitis is highest in December(83 cases),but statistical analysis shows that the incidence of uveitis has no correlation with the month.3.The mean BCVA of anterior,interior,posterior and panuveitis is 0.58±0.75 Log MAR,0.35±0.56 Log MAR,0.72±0.69 Log MAR and 0.89±0.93 Log MAR.4.Cataract(409 cases,49.10%),intraocular hypertension(106 cases,12.72%)and macular epiretinal membrane(99 cases,11.89%)were the leading complications.5.140 uveitic cataract patients were reviewed.The patients in IVTA group and control group were preliminarily determined according to whether they were combined with 3mg TA injection after phacoemulsification.The patients in the two groups were finally enrolled in IVTA group(41 patients,51 eyes)and control group(41 patients,51 eyes)after propensity score matching.Two types of uveitic cataract found in our study,including anterior uveitis and panuveitis.There was no significant difference in baseline characteristics between the two groups.6.IVTA group had significantly less postoperative anterior chamber cells(P<0.05)as compared to control group after surgery.The postoperative log MAR BCVA of anterior uveitis was better and improved more quickly in IVTA group(P<0.05).Postoperative time of using corticosteroids in IVTA group was shorter than control group(P<0.05).The CMT of IVTA group was statistically significantly lower(P<0.05)than control group at postoperative 1 month.There were no statistically significant differences in postoperative corneal endothelial cell density and IOP between the two groups(P>0.05).7.During 3 months of postoperative follow-up,2 of 51 eyes(3.9%)in IVTA group and 8 of 51 eyes(15.7%)in control group had recurrence of uveitis;6 of 45 eyes(13.3%)in control group developed CME but none in IVTA group;11 of 51 eyes(21.6%)in IVTA group and 22 of 51 eyes(43.1%)in control group developed posterior synechiae postoperatively.Conclusion:1.In Shanxi province,anterior uveitis and panuveitis are the most common anatomical classifications of uveitis.More than half of the patients with uveitis had an identifiable cause.VKH,BD,HLA-B27-associated uveitis and Fuchs syndrome were the most common uveitis entities.The incidence ratio of ARN in our center was 4.94%,higher than other centers.Patients with panuveitis uveitis have the worst vision in four types.The incidence of uveitis has no correlation with the month.Cataract,intraocular hypertension and macular epiretinal membrane were the leading complications.2.Intravitreal injection of low-dose 3mg TA during phacoemulsification is an effective and safe adjunctive option for preventing postoperative inflammation and complications to promote early recovery in anterior uveitis or panuveitis cataract. |
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