Causas das uveítes em serviço terciário em São Paulo, Brasil

Abstract

PURPOSE: To analyze retrospectively the diagnosis of patients being followed up at the Uveitis Service of Hospital das Clinicas, University of Sao Paulo Medical School, during a 6-month period, from February to August, 2002. METHODS: 262 patients, who attended the Uveitis Service during that period, had their charts reviewed and their diagnoses confirmed during the appointment. The following data were analyzed: age, gender, anatomic and etiological diagnoses, disease activity and ocular complications. RESULTS: Patients' mean age was 41 years, 60% being female and 40% male. Distribution according to anatomic diagnosis was: anterior 20%, intermediate 4.5%, posterior 39.7 % and diffuse 31.3 %. Uveitis etiology was determined in 80% of the cases, and the most common causes were toxoplasmosis 22%, Vogt-Koyanagi-Harada syndrome 13% and Behcet's disease 10%. Infectious causes were present in 79% of posterior uveitis, whereas non-infectious systemic diseases were observed in 61% of anterior and 73% of diffuse uveitis. Uncommon diagnoses were observed such as HTLV-I/II related-uveitis, antiphospholipid syndrome and autoimmune retinopathy. Concerning disease activity, 15% were active and 85% were inactive. The most frequent ocular complications were cataract (42%) and glaucoma (13%). CONCLUSIONS: Epidemiological studies may demonstrate different patterns of uveitis of etiology; nevertheless they also reflect the particular characteristics of each center (tertiary, diagnosis criteria, special interests). The present study demonstrates in our midst the importance of endogenous uveitis such as Vogt-Koyanagi-Harada syndrome and Behcet's disease, as well as of infectious uveitis such as toxoplasmosis and toxocariasis.