Clinical Characteristics of Uveitis in Patients with Psoriasis in Korea: A Retrospective Multicenter Case Series
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Purpose: To describe the clinical characteristics and treatment outcomes of uveitis in patients with psoriasis in Korea. Methods: The medical records of 20 patients (27 eyes) with psoriatic uveitis in two tertiary hospitals were retrospectivelyreviewed. We analyzed data about patient demographics, uveitis types, laterality, onset of disease, human leukocyte antigen(HLA) types, intraocular pressure, visual acuity, comorbidities, and medical treatments and outcomes for uveitis and psoriasis. Results: The cohort comprised 11 males and nine females (age of onset, 50.1 ± 13.2 years) and the mean follow-up periodwas 3.9 ± 4.0 years. Types of uveitis included anterior (85%), intermediate (10%), and panuveitis (5%). A total of 13 (65%)cases presented with unilateral involvement and 12 out of 18 patients (66.7%) were positive for HLA-B27. The average intraocularpressure of affected eyes was 11.6 ± 3.6 at the first visit and 13.8 ± 3.6 mmHg at the final visit. The average logarithmof the minimum angle of resolution visual acuity of affected eyes at the initial examination was 0.16 ± 0.52 and 0.27 ± 0.71 atthe last examination. Most common comorbidity (13 patients, 65%) was psoriatic arthritis (PsA). All cases underwent topicalcorticosteroid treatment; however, 11 (55%) required systemic corticosteroid and immunosuppressants for the treatment ofuveitis. Notable deterioration in visual outcome was found in two cases (10%) due to severe intraocular inflammation and itscomplications (uveitic glaucoma and bullous keratopathy). Recurrent uveitis was observed in 57.9% of patients. Patients withPsA tended to have higher positive rate of HLA-B27 (83.3%). However, there was no significant correlation between visualprognosis and location of psoriatic uveitis, presence of PsA, and HLA-B27 positivity. Conclusions: Psoriatic uveitis in Koreans usually presents with anterior uveitis with unilateral involvement. PsA was the mostcommon comorbidity. In majority of patients, visual outcomes are satisfactory with appropriate topical or systemic immunosuppressivetreatment.
Abstract
Purpose: To describe the clinical characteristics and treatment outcomes of uveitis in patients with psoriasis in Korea. Methods: The medical records of 20 patients (27 eyes) with psoriatic uveitis in two tertiary hospitals were retrospectivelyreviewed. We analyzed data about patient demographics, uveitis types, laterality, onset of disease, human leukocyte antigen(HLA) types, intraocular pressure, visual acuity, comorbidities, and medical treatments and outcomes for uveitis and psoriasis. Results: The cohort comprised 11 males and nine females (age of onset, 50.1 ± 13.2 years) and the mean follow-up periodwas 3.9 ± 4.0 years. Types of uveitis included anterior (85%), intermediate (10%), and panuveitis (5%). A total of 13 (65%)cases presented with unilateral involvement and 12 out of 18 patients (66.7%) were positive for HLA-B27. The average intraocularpressure of affected eyes was 11.6 ± 3.6 at the first visit and 13.8 ± 3.6 mmHg at the final visit. The average logarithmof the minimum angle of resolution visual acuity of affected eyes at the initial examination was 0.16 ± 0.52 and 0.27 ± 0.71 atthe last examination. Most common comorbidity (13 patients, 65%) was psoriatic arthritis (PsA). All cases underwent topicalcorticosteroid treatment; however, 11 (55%) required systemic corticosteroid and immunosuppressants for the treatment ofuveitis. Notable deterioration in visual outcome was found in two cases (10%) due to severe intraocular inflammation and itscomplications (uveitic glaucoma and bullous keratopathy). Recurrent uveitis was observed in 57.9% of patients. Patients withPsA tended to have higher positive rate of HLA-B27 (83.3%). However, there was no significant correlation between visualprognosis and location of psoriatic uveitis, presence of PsA, and HLA-B27 positivity. Conclusions: Psoriatic uveitis in Koreans usually presents with anterior uveitis with unilateral involvement. PsA was the mostcommon comorbidity. In majority of patients, visual outcomes are satisfactory with appropriate topical or systemic immunosuppressivetreatment.
참고문헌 (22)
- Chandran NS, "Psoriasis and the eye: prevalence of eye disease in Singaporean Asian patients with psoriasis", J Dermatol, 34, pp.805~810 (2007)
- Gudjonsson JE, "Psoriasis: epidemiology", Clin Dermatol, 25, pp.535~546 (2007)
- Chi CC, "Risk of uveitis among people with psoriasis: a nationwide cohort study", JAMA Ophthalmol, 135, pp.415~422 (2017)
- Tanaka R, "Clinical features of psoriatic uveitis in Japanese patients", Graefes Arch Clin Exp Ophthalmol, 253, pp.1175~1180 (2015)
- Yang P, "Uveitis in Chinese patients with psoriasis", Ocul Immunol Inflamm, 25, pp.855~865 (2017)
- 이진용, "Prevalence of Psoriasis in Korea: A Population-Based Epidemiological Study Using the Korean National Health Insurance Database", Annals of Dermatology, 29(6), pp.761~767 (2017), 대한피부과학회
- Menter A, "Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies", J Am Acad Dermatol, 60, pp.643~659 (2009)
- Kilic B, "Ocular findings in patients with psoriasis", Int J Dermatol, 52, pp.554~559 (2013)
- Abbouda A, "Psoriasis and psoriatic arthritis-related uveitis: different ophthalmological manifestations and ocular inflammation features", Semin Ophthalmol, 32, pp.715~720 (2017)
- Knox DL, "Psoriasis and intraocular inflammation", Trans Am Ophthalmol Soc, 77, pp.210~224 (1979)
- Griffiths CE, "Pathogenesis and clinical features of psoriasis", Lancet, 370, pp.263~271 (2007)
- Lange C, "Resolving the clinical acuity categories “hand motion” and “counting fingers” using the Freiburg Visual Acuity Test (FrACT)", Graefes Arch Clin Exp Ophthalmol, 247, pp.137~142 (2009)
- Jabs DA, "Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop", Am J Ophthalmol, 140, pp.509~516 (2005)
- Ogawa E, "Pathogenesis of psoriasis and development of treatment", J Dermatol, 45, pp.264~272 (2018)
- Burden-Teh E, "Psoriasis and uveitis: should we be asking about eye symptoms?", Br J Dermatol, 170, pp.756~757 (2014)
- Durrani K, "Psoriatic uveitis: a distinct clinical entity?", Am J Ophthalmol, 139, pp.106~111 (2005)
- Fraga NA, "Psoriasis and uveitis: a literature review", An Bras Dermatol, 87, pp.877~883 (2012)
- Egeberg A, "Association of psoriatic disease with uveitis: a danish nationwide cohort study", JAMA Dermatol, 151, pp.1200~1205 (2015)
- El-Asrar AM, "Cytokine profiles in aqueous humor of patients with different clinical entities of endogenous uveitis", Clin Immunol, 139, pp.177~184 (2011)
- Watanabe Y, "Therapeutic effects for infliximab in psoriatic uveitis: case report and review of the literature in Japan", Jpn J Dermatol, 122, pp.2321~2327 (2012)
- Di Cesare A, "The IL-23", Th17 axis in the immunopathogenesis of psoriasis, 2009, pp.129, 1339~1350
- Tay-Kearney ML, "Clinical features and associated systemic diseases of HLA-B27 uveitis", Am J Ophthalmol, 121, pp.47~56 (1996)