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Amr Kouchouk, Monica Dalal, H Nida Sen, Robert Nussenblatt, Landon Grange, Mahdi Rostamizadeh; Masquerade Syndromes. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2945.
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Masquerade syndromes are neoplastic or nonneoplastic conditions that present as uveitis. The goal of our study is to identify the proportion of patients with masquarade syndrome in a tertiary uveitis clinic and determine the baseline clinical characteristics of patients with masquerade syndromes
All patients that presented with uveitis were identified by electronic medical record database search from 2004-2012. Non-malignant masquerade syndromes such as retinal detachment, trauma or infection were not included in our search. Demographic and clinical data such as age at onset of disease, initial and final diagnosis, intraocular inflammation and visual acuity were collected on all patients. Clinical characteristics at presentation were then compared between the masquerade syndrome group and the uveitis group.
A total of 855 patients with “uveitis” as the presenting diagnosis were identified. Of these 23 (2.69%) were determined to be neoplastic masquerade syndromes. The most common masquerade syndrome was primary intraocular lymphoma (PIOL). 772 of the 832 non-masquerade uveitis patients had non-infectious autoimmune uveitis (92.8%) whereas 60 (7.2%) had infectious uveitis. The average age of patients with masquerade syndromes at presentation was 57.5 (range 41-77) whereas the average age of uveitis cases was 46.2 (range 4-98). The M:F ratio was 1.1:1 among patients with masquerade syndrome and 0.7:1 amongst uveitis patients. Average visual acuity (logMAR) on presentation was 0.51 in the masquerade syndrome group, and 0.37 in the uveitis group. On initial visit 15/19 (65.2%) of masquerade syndrome patients had active anterior chamber, vitreous or inflammation of both .
Our data suggests that there is a difference between the presenting characteristics of patients with masquerade syndromes and those with uveitis. Patients with masquerade syndromes tend to be older, with lower visual acuity on presentation. Diagnosis of masquerade syndromes is difficult, but clinical characteristics may help raise suspicion for differentiating neoplastic masquarade syndromes from uveitis.
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