全身性紅斑狼瘡眼科疾病之盛行率與風險因子：單一中心的回溯性分析

Prevalence of ocular diseases in patients with systemic lupus erythematosus: a single center experience retrospective analysis

目的：確認全身性紅斑狼瘡病人的眼科疾病之盛行率與風險因子。方法：本研究是回溯性觀察型研究，於台大醫院進行。收錄病人的條件為：1）長期全身性紅斑狼瘡的患者；2）於2019年1月至2021年1月之間接受眼科醫師檢查。我們藉由病歷回顧的方式記錄患者的基本資料、臨床特徵及眼科診斷，進行後續分析。結果：本研究共收錄121位全身性紅斑狼瘡的患者。最常見的三種眼科疾病為乾眼（121位中有8位，39.7%）、近視（121位中有39位，32.2%）及白內障（121位中有21位，17.4%）。另外有9名青光眼的患者（7.4%）。進一步分析發現，乾眼的患者較少合併血液學表現（P = 0.018）、有較長的紅斑狼瘡罹病時間（P < 0.001）。白內障則與較長的紅斑狼瘡罹病時間（P < 0.001）及接受眼科檢查時較大的年紀（P < 0.001）有關。近視及青光眼則未發現與任何臨床因素有關。結論：長期全身性紅斑狼瘡的患者常見合併眼科疾病，有些可能與慢性發炎的狀態有關。多專科的評估有助於診斷眼科的合併症，對於早期介入和追蹤有很大的幫助。

Objective: To identify the prevalence and the risk factors of ocular diseases in patients with systemic lupus erythematosus (SLE).Methods: This is a retrospective observational study in National Taiwan University Hospital, a tertiary hospital in northern Taiwan. Inclusion criteria were as follows: 1) patients with longstanding SLE, and 2) patients who received ophthalmic evaluation during the period of January 2019 to January 2021. Demographic and clinical data, ophthalmic diagnoses were recorded by chart review.Results: A total of 121 patients were included. Dry eye (48 of 121, 39.7%), myopia (39 of 121, 32.2%), and cataract (21 of 121, 17.4%) were the most common findings. Also, glaucoma was diagnosed in 9 patients (7.4%). Further analysis revealed positive correlation between dry eye and less occurrence of hematologic presentations (P = 0.031) and longer disease duration (P = 0.018). Cataract was significantly associated with longer disease duration (P < 0.001) and higher age at ophthalmic evaluation (P < 0.001). No significant factors were found to be associated with myopia and glaucoma.Conclusions: Ocular diseases are common in patients with longstanding SLE, and these may reflect the underlying inflammation of the ocular structures. Multidisciplinary evaluation would help to detect ophthalmic conditions. Early intervention and close monitoring are of paramount importance.