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Rheumatol Int ; 39(3): 489-495, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30706192

RESUMO

Ocular involvement is present in 50-60% of granulomatosis with polyangiitis (GPA) patients and can affect any part of the ocular globe. The present study describes ophthalmologic manifestations, association with systemic symptoms, disease activity and damage in GPA. A cross-sectional study was conducted including patients with GPA who underwent rheumatologic and ophthalmologic evaluation. Demographics, comorbidities, ophthalmologic symptoms, serologic markers, radiographic studies, disease activity and damage were assessed. Descriptive statistics, correlation, univariable logistic regression analyses, Student's t, Mann-Whitney U, Chi-square and Fisher's exact tests were performed. Fifty patients were included, 60% female, the median age was 56 years, disease duration 72.5 months. Nineteen (38%) patients had ocular manifestations at GPA diagnosis, scleritis being the most frequent; 27 (54%) patients presented ocular involvement during follow-up, repeated scleritis and dacryocystitis being the most common manifestations. Concomitant ophthalmic and sinonasal involvement was present in 12 (24%). Ocular and ENT damage occurred in 58% and 70%, respectively. Epiphora and blurred vision were the most frequent symptoms; scleromalacia and conjunctival hyperemia (27%) the most frequent clinical abnormalities. Ocular involvement at diagnosis was associated with concomitant ocular and sinonasal involvement at follow-up (OR 4.72, 95% CI 1.17-19.01, p = 0.01). Ocular involvement at follow-up was associated with age at GPA diagnosis (OR 0.94, 95% CI 0.90-0.99, p = 0.03), VDI (OR 1.29, 95% CI 1.03-1.61, p = 0.02), and ENT damage (OR 5.27, 95% CI 1.37-20.13, p = 0.01). In GPA, ocular involvement is frequent, therefore, non-ophthalmologist clinicians should be aware of this manifestation to reduce the risk of visual morbidity and organ damage.


Assuntos
Dacriocistite/fisiopatologia , Granulomatose com Poliangiite/fisiopatologia , Doenças Nasais/fisiopatologia , Doenças dos Seios Paranasais/fisiopatologia , Esclerite/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças da Túnica Conjuntiva/etiologia , Doenças da Túnica Conjuntiva/fisiopatologia , Estudos Transversais , Dacriocistite/etiologia , Oftalmopatias/etiologia , Oftalmopatias/fisiopatologia , Feminino , Granulomatose com Poliangiite/complicações , Humanos , Hiperemia/etiologia , Hiperemia/fisiopatologia , Doenças do Aparelho Lacrimal/etiologia , Doenças do Aparelho Lacrimal/fisiopatologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Doenças Nasais/etiologia , Doenças dos Seios Paranasais/etiologia , Esclerite/etiologia , Transtornos da Visão/etiologia , Transtornos da Visão/fisiopatologia , Adulto Jovem
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