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K. S. Oswal, R. Sivaraj, P. Stavrou, P. I. Murray; Initial Presentation of Uveitis in Patients With Diabetes Mellitus. Invest. Ophthalmol. Vis. Sci. 2009;50(13):295.
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Diabetes mellitus (DM) and uveitis both cause breakdown of blood-ocular barriers. Little is known about the characteristics of uveitis when it occurs in patients with DM.We report the presenting clinical features of a first attack of uveitis in patients with DM.
Cross-sectional analysis of patients with DM presenting with uveitis.
A total of 31 patients (M/F:14/17, 45 eyes) were included. Mean age of onset of DM was 49 years and for uveitis 57 years. All patients except one had type 2 DM, the majority (19) on oral hypoglycaemics. Uveitis was bilateral in 14 (45%) patients. 20 had anterior uveitis, 9 panuveitis, and 2 intermediate uveitis. Uveitis was idiopathic in 19, 3 had Fuchs’ heterochromic cyclitis, 2 had sarcoidosis, 2 had HLA-B27 related uveitis, and 1 had rheumatoid arthritis. In 4 patients there was an infectious cause (2 tuberculosis, 1 toxoplasmosis, and 1 syphilis). Visual acuity was 6/12 or better in 20 eyes, 6/18-6/60 in 14 eyes, and worse than 6/60 in 11 eyes (24%). 16 eyes had 3-4+ flare, and 13 eyes 3-4+ cells in the anterior chamber (AC). There were 22 eyes with posterior synechiae, 11 eyes with raised IOP/glaucoma, and 4 eyes with cystoid macular oedema. Diabetic retinopathy was seen in 18 (40%) eyes (non-proliferative 13 eyes, proliferative 5 eyes). Mean HbA1c in 7 patients was 8.73%, (range 6.5-13.4%).
Diabetic patients presenting with uveitis may have severe AC inflammation, visual acuity worse than 6/60, and evidence of poor glycaemic control.
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