METHODS: Eighty-seven patients diagnosed with brucellosis and 71 healthy cases (as a control group) were enrolled in this prospective study. All participants underwent a complete ophthalmic evaluation, including slit lamp biomicroscopic examination, Goldman applanation tonometry, specular microscopy, optical coherence tomography and fundoscopy with pupil dilation.
RESULTS: Overall, ocular involvement was present in 47 eyes of 27 (31.03%) patients diagnosed with brucellosis and was most common in the chronic brucellosis group. In the acute brucellosis group, papillary conjunctivitis in 8 eyes of 4 patients and anterior uveitis in 10 eyes of 6 patients were noted. In the subacute brucellosis group, papillary conjunctivitis in 4 eyes of 2 patients and sequelae of anterior uveitis in 6 eyes of 3 patients were observed. In the chronic brucellosis group, panuveitis in 4 eyes of 2 patients, choroiditis in 4 eyes of 2 patients, and signs of previous anterior uveitis in 11 eyes of 6 patients were noted. Visual acuity was significantly worse in patients with acute anterior uveitis (AAU) or previous anterior uveitis (PAU) compared with the control cases.
CONCLUSIONS: Ocular involvement should be kept in mind in patients with brucellosis, especially acute, and brucellosis should be included in the differential diagnosis of patients with anterior uveitis living in endemic areas, since the clinical presentation of the disease may not be overt.
方法:本前瞻性研究纳入87例确诊为布氏杆菌病的患者和71例健康者(作为对照组)。所有参与者都接受了完整的眼科评估,包括裂隙灯生物显微镜检查,高盛的压平眼压计,镜面显微镜,光学相干层析成像和眼底镜与瞳孔扩张。
结果:总体而言,27例(31.03%)被诊断为布氏杆菌病的患者中,有47只眼出现眼部受累,在慢性布氏杆菌病组最为常见.在急性布鲁氏菌病组,4例患者有8只眼乳头状结膜炎,6例患者有10只眼前葡萄膜炎。在亚急性布鲁氏菌病组,观察到2例4眼乳头状结膜炎和3例6眼的前葡萄膜炎后遗症。在慢性布鲁氏菌病组中,2例患者的4只眼全葡萄膜炎,2例患者的4只眼脉络膜炎,并注意到6例患者中11只眼的前葡萄膜炎征象。与对照组相比,患有急性前葡萄膜炎(AAU)或先前的前葡萄膜炎(PAU)的患者的视力明显更差。
结论:布鲁氏菌病患者应注意眼部受累,尤其是急性,布鲁氏菌病应该包括在流行地区的前葡萄膜炎患者的鉴别诊断中,因为这种疾病的临床表现可能不是公开的。