Üveitlere Romatolojik Yaklaşım

Yıl 2019, , 150 - 159, 20.12.2019

Sertaç Ketenci , Ender Salbaş

https://doi.org/10.33713/egetbd.644034

Öz

Özet: Üveit terimi gözün kanlanmasını sağlayan katmanların inflamasyonunu ifade eder. Altta yatan neden idiyopatik olabileceği gibi, enfeksiyonların, romatolojik hastalıkların, ilaç yan etkilerinin bir yansıması olarak da karşımıza çıkabilir. Etiyolojisinde sistemik inflamatuvar patolojilerin yoğun olarak yer alması nedeniyle üveit tanılı hastaları oftalmologlar dışında en sık gören hekimler romatologlardır. Tanı, tedavi ve takip açısından en sık kullanılan sınıflandırma olan anatomik sınıflandırmada üveitler ön, orta, arka ve pan üveit olarak 4 ana grupta ele alınır. Ön üveitler, tüm üveitlerin %80’ini oluşturur. Sebepleri olarak ön planda idiyopatik üveitler, spondiloartropatiler (SpA), herpetik virüsler ve Behçet hastalığı sayılabilir. Akut ön üveitli (AAU) hastalar kliniğe kızarık göz, fotofobi ve ağrı ile başvurur. Tipik olarak tek gözde inflamasyon görülür. Nadiren iki taraflı ataklar da saptanabilir. Kronik ön üveite Romatoloji pratiğinde AAU’ya göre daha nadir rastlanılmakla beraber, en sık ilişkili olduğu durum Jüvenil İdiyopatik Artrittir (JİA). Orta Üveite (IU) neden olan en sık iki etken Multipl Skleroz (MS) ve Sarkoidozdur. Diğer hastalıklar Sifiliz, Toksoplazma, Toksokara, Tüberküloz, EBV enfeksiyonları şeklinde sıralanabilir. Ön üveitlerde beklenen kırmızı göz, ağrı gibi semptom ve bulgular arka üveitlerde beklenmez. Ülkemizde arka üveit tanılı hastaların %40’tan fazlasında Behçet Hastalığı bildirilmekteyken,  Avrupa verilerinde idiyopatik üveitler, enfeksiyonlar ve Sarkoidoz gibi sebepler ön planda gözlenmektedir. Ülkemizde yapılan çalışmalarda panüveit sıklığı %26,7 ile ön üveitten sonraki ikinci en sık üveit grubunu oluşturur. Behçet Hastalığı ve idiyopatik panüveit önde gelen iki sebebi oluşturmaktadır. Bu derleme ile üveitlerin romatoloji penceresinden kapsamlı olarak ele alınması amaçlanmıştır.


 


Abstract: The term uveitis refers to inflammation of the layers that provide blood to the eye. The underlying cause may be idiopathic or reflection of infections, rheumatologic diseases and as a drug side effect. Due to the involvement of systemic inflammatory pathologies in the etiology; Rheumatologists are the most common physicians who see uveitis patients except ophthalmologists. According to anatomical structure, uveitis is classified into 4 main groups as anterior, middle, posterior and pan uveitis. This grouping; is the most commonly used classification in terms of diagnosis, treatment and follow - up. Anterior uveitis accounts for 80% of all uveitis. The causes of anterior uveitis include idiopathic uveitis, spondyloarthropathies (SpA), herpetic viruses and Behçet's disease. Patients with acute anterior uveitis (AAU) have complaints of red-eye, photophobia and pain. Inflammation is typically seen in one eye. Rarely, bilateral attacks can also be found. Chronic anterior uveitis is less common in rheumatology practice than AAU, but it’s most common association is Juvenile Idiopathic Arthritis (JIA). The two most common causes of intermediate uveitis (IU) are Multiple Sclerosis (MS) and Sarcoidosis. Other diseases include Syphilis, Toxoplasma, Toxocara, Tuberculosis, EBV infections. Symptoms and signs such as red eye and eye pain that expected in anterior uveitis are not expected in posterior uveitis. Behçet's disease has been reported in more than 40% of the patients with posterior uveitis in Turkey, while European data shows that idiopathic uveitis, infections and sarcoidosis are the main causes for posterior uveitis. In Turkey, the prevalence of panuveitis is 26.7% and it is the second most common uveitis group after anterior uveitis. Behçet's disease and idiopathic panuveitis are two leading causes. The aim of this review is to investigate the uveitis from rheumatology window comprehensively.

Anahtar Kelimeler

romatoloji, üveit

Kaynakça

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