Clinical features of the course of optic neuritis as a complication of idiopathic anterior uveitis
DOI:
https://doi.org/10.31288/oftalmolzh202154146Keywords:
idiopathic anterior uveitis, complications, optic neuritis, clinical featuresAbstract
Background: Uveitis is the fifth leading cause of visual impairment in developed countries and responsible for about 20% of legal blindness. A serious complication of anterior uveitis, optic neuritis, as well as the factors contributing to its development has not been investigated completely, but its early diagnosis is a challenge.
Purpose: To reveal the features of the clinical course of optic neuritis as a complication of idiopathic anterior uveitis.
Material and Methods: This study involved 150 patients with unilateral idiopathic anterior uveitis who were examined and treated at the Filatov Institute. Of these, 114 did not have signs of optic neuritis, and 34 had optic neuritis in the presence of uveitis. Patients underwent an eye examination including visual acuity, ophthalmoscopy, biomicroscopy, intraocular pressure (IOP) measurement, and Humphrey perimetry. Treatment involved antibiotics, non-steroidal anti-inflammatory drugs, immune suppressors, corticosteroids, and biological immune response modulators.
Results: The clinical features related to inflammation were more severe in the group of patients with optic neuritis as a complication of anterior uveitis than in the group of patients with uncomplicated uveitis. Particularly, the number of keratic precipitates was high in 69.7%, hypopyon was present in 83.3%, and vitreous haze was intensive or apparent in all patients of the former group, versus no patients, one patient and 4.4% of patients, respectively, of the latter group. The number of keratic precipitates was moderately positively correlated with the development of optic neuritis in patients with anterior uveitis, (Spearman ρ, 0.566; p < 0.05). Concomitant otorhinolaryngological and odontogenic inflammatory diseases were found in 82.5% of patients with anterior uveitis. There was a significant positive association between the presence of concomitant otorhinolaryngological and odontogenic inflammatory diseases and the development of optic neuritis in patients with anterior uveitis (χ2=5.50, p=0.0191).
References
1. Fardeau C, Champion E, Massamba N, Lehoang P. Uveitic macular edema. Eye. 2016; 30(10):1277-92. https://doi.org/10.1038/eye.2016.115
2. Anesi SD, Foster CS. Anterior uveitis: etiology and treatment. Advanced Ocular Care. 2011;2(1):32-4.
3. Miserocchi E, Fogliato G, Modorati M, Bandello F. Review on the worldwide epidemiology of uveitis. Eur J Ophthalmol. 2013; 23: 705- 717.https://doi.org/10.5301/ejo.5000278
4. Arbenyeva NS, Chekhova TA, Bratko GV, Chernykh VV. [Comparative analysis of the incidence of patients with uveitis]. In: [Current issues of ophthalmology: a collection of science works. Proceedings of the 7th National Russian Conference of Young Scientists]. Editor, B.E. Malyugin. Moscow: Ophthalmology; 2012. p. 28-9. Russian.
5. McCannel CA, Holland GN, Helm CJ, et al. Causes of uveitis in the general practice of ophthalmology. UCLA Community-Based Uveitis Study Group. Am J Ophthalmol. 1996; 121 (1): 35-46. https://doi.org/10.1016/S0002-9394(14)70532-X
6. Panova IE, Drozdova IE. [Uveitides: a manual for physicians]. Moscow: Meditsinskoie informatsionnoie agenstvo; 2014. Russian.
7. Nussenblatt RB, Whitcup SM, editors. Uveitis: fundamental and clinical practice. 4th ed. Elsevier/Mosby; 2012.
8. Emmett T Cunningham, Zierhut M. Uveitic Macular Edema. Ocul Immunol Inflamm. 2018;26(7):987-90,https://doi.org/10.1080/09273948.2018.1529466
9. Khramenko NI, Konovalova NV. Findings of ocular and brain hemodynamics in patients with anterior uveitis complicated by macular edema. J Ophthalmol (Ukraine). 2020; 4:14-22.
10. Panchenko NV, Samofalova MN, Gonchar EN, Litvishchenko AV, Friantseva MV. [Thinning of the peripapillary nerve fiber layer in uveitis complicated by optic nerve inflammation]. Archive of Ukrainian ophthalmology. 2016;3(1):50-3. Russian.
11. Penkov MA, Shpak NI, Avrushchenko NM. [Endogenous uveitis]. Kyiv: Zdorov'ia; 1979. Russian.
12. Jabs DA, Nussenblatt RB, Rosenbaum JT. Standardization of Uveitis Nomenclature (SUN) Working Group. Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol. 2005; 140(3): 509- 516.https://doi.org/10.1016/j.ajo.2005.03.057
13. Deschenes J, Murray PI, Rao NA, Nussenblatt RB. & International Uveitis Study Group. International Uveitis Study Group (IUSG): clinical classification of uveitis. Ocul Immunol Inflamm. 2008; 16: 1-2.https://doi.org/10.1080/09273940801899822
14. McNeil R. Grading of ocular inflammation in uveitis: an overview. Eye news. 2016; 22 (5): Fabruary/March; Available at: http://www.eyenews.uk.com.
15. Glanz S. [Biomedical statistics]. Moscow: Praktika;1998. Russian.
16. Cimino L, Auer C, Herbort CP. Sensitivity of indocyanine green angiography for the follow-up of active inflammatory choriocapillaropathies. Ocul Immunol Inflamm. 2000; 8(4): 275-83.https://doi.org/10.1076/ocii.8.4.275.6462
17. Ioyleva ЕЕ, Krivosheeva MS, Smirnova MA. [Unilateral optic disc edema: features of the differential diagnosis]. Tavricheskii medikobiologicheskii vestnik. 2013;(3):166-70. Russian.
18. Ioyleva E, Krivosheeva M. Microperimetry in the diagnosis of the first manifestation of optic neuritis in multiple sclerosis. J Neurol Sci. 2015; 357: 47.https://doi.org/10.1016/j.jns.2015.08.196
19. Trusko B, Thort J, Jabs D et al. The Standardization of Uveitis Nomenclature (SUN) Project. Development of clinical evidence base utilizing informatics tools and techniques. Methods Inf Med. 2013; 7. 52 (3): 259-265.https://doi.org/10.3414/ME12-01-0063
20. Bennett JL. Optic Neuritis. Continuum (Minneap Minn). 2019; 25(5): 1236-64.https://doi.org/10.1212/CON.0000000000000768
21. Shantha GJ, Crozier I, Hayek BR, Bruce BB, Gargu C, Brown J, Fankhauser J, Yeh S. Ophthalmic Manifestations and Causes of Vision Impairment in Ebola Virus Disease Survivors in Monrovia, Liberia. Ophthalmology. 2017; 124(2): 170-177. doi:10.1016/j.ophtha.2016.10.011.HHS Public Access.https://doi.org/10.1016/j.ophtha.2016.10.011
22. Smit RL, Baarsma GS, de Vries J. Classification of 750 consecutive uveitis patients in the Rotterdam Eye Hospital. J Int Ophthalmol. 1993; 17(2):71-76.https://doi.org/10.1007/BF00942778
23. Beck RW, Cleary PA, Anderson MM et al. A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med. 1992; 326(9): 581-8.https://doi.org/10.1056/NEJM199202273260901
24. Whitley W, Sheppard J. The basics of uveitis. Rev Optom. 2011; Available at: http://www.reviewofoptometry.com/continuingeducation/tabviewtest/lessoni.
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