Abstract
Purpose :
To examine the frequency of retinal vasculitis (arteritis and phlebitis ) in the patients with infectious and non-infectious uveitis.
Methods :
We investigated 352 patients (186 men, 166 women ;mean age 51.2±17.2 years old) who visited the Uveitis Clinic of the University of Tokyo hospital in 2001-2017, who had suffered intermediate, posterior or pan-uveitis and were definitely diagnosed with infectious or non-infectious uveitis. All patients received fluorescence angiography and color photography in order to assess inflammatory activities .. Three doctors (H.O., T.K., R.T.) independently judged the presence or absence of fern-like fluorescence leakage, retinal arteritis and phlebitis, vascular sheathing and occlusions of retinal arteries and veins, non-perfusion areas using fluorescence angiography and color fundus photography. The positive ratios of those findings between infectious uveitis group (tuberculosis, syphilis, acute retinal necrosis, cytomegalovirus retinitis, fungal endophthalmitis, HTLV-1 associated uveitis, ocular toxoplasmosis, ocular toxocariasis,bacterial endophthalmitis) and non-infectious uveitis group (Behcet's disease, sarcoidosis, Vogt-Koyanagi-Harada disease, sympathetic ophthalmia, ocular psoriasis, HLA-B27 associated uveitis, retinal vasculitis in systemic lupus erythematosus,Tubuloinstitial nephritis and uveitis syndrome) were compared. The research followed the tenets of the Declaration of Helsinki. All participants provided informed consent. This retrospective study was approved by the Institutional Review Board of The University of Tokyo Hospital.
Results :
In infectious uveitis group (n= 114), the positive ratios of fern-like leakage, phlebitis, sheathing of veins, occlusions in veins, arteritis, sheathing of arteries, occlusions in arteries, and non- perfusion areas were 54%, 76%, 36%, 23%, 54%, 43%, 25% and 36%, respectively. On the other hand, in non-infectious uveitis group (n= 238), they were 57%, 59%, 12%, 3.8%, 7.1%, 5.9%, 3.8% and 13%, respectively. Compared with the non-infectious group, significantly higher positive ratios of sheathing of veins, occlusions in veins, arteritis, sheathing of arteries, occlusions in arteries, and non- perfusion areas were observed in the infectious group (p<.0001).
Conclusions :
Our results demonstrated that findings of retinal vasculitis, especially arteritis, could strongly suggest the infectious origin.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.