目的：评估活动性葡萄膜炎对屈光不正变化的影响。

方法：这是一项前瞻性队列研究，纳入66例88眼活动性葡萄膜炎患者。受试者根据其疾病活动的解剖位置分为前、中、后和全葡萄膜炎。在活动期和静止期均行睫状肌麻痹验光，并对结果进行比较。

结果：活动性前非肉芽肿性葡萄膜炎的球镜变化导致平均 -0.25(0.77)D(95% CI： -0.5～0)的近视转变(P=0.039)，在活动性中层葡萄膜炎中，平均 +0.39(0.8)D(95% CI： 0.09～0.69)的远视转变(P=0.003)。活动性中层葡萄膜炎的等效球镜的变化导致远视转变 \〖+0.43(0.94)D， 95% CI： 0.08～0.79， P=0.005\〗。柱镜仅在全色素膜炎时有明显改变 \〖-0.3(0.39)D， 95% CI： -0.58～-0.02， P=0.043\〗。在多元分析中，我们发现疾病活动过程(急性与复发)和疾病活动的解剖位置对等效球镜变化具有统计学意义(分别为P=0.003和P=0.004)

结论：活动性葡萄膜炎对屈光度有重要影响，该变化取决于具体的炎症发生部位。

METHODS: A prospective cohort study was conducted on 66 patients(88 eyes)with active uveitis. The subjects were classified based on the anatomical location of their disease activity as anterior, intermediate, posterior and pan-uveitis. Cycloplegic refraction was performed in both active and quiescent phases, and the results were compared.

RESULTS: Spherical changes in active anterior non-granulomatous uveitis resulted in an average of -0.25(0.77)D(95% CI: -0.5 to 0)shift toward myopia(P=0.039)and in active intermediate uveitis, an average of +0.39(0.8)D(95% CI: 0.09-0.69)shift toward hyperopia(P=0.003). Spherical equivalent changes in active intermediate uveitis resulted in hyperopic shift \〖+0.43(0.94)D, 95% CI: 0.08-0.79, P=0.005\〗. Cylinder had only significant changes in pan-uveitis \〖-0.3(0.39)D, 95% CI: -0.58 to -0.02, P=0.043\〗. In multivariate analysis, we noted that course of disease activity(acute versus recurrent)and anatomical location of disease activity had statistically significant effects on spherical equivalent changes(P=0.003 and P=0.004, respectively).

CONCLUSION: Active uveitis has a significant effect on the refractive status of the eye, the changes of which depend on the inflamed anatomical area.