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Wannapanich T, Chuenchaem W, Luanratanakorn P, Laovirojjanakul W. Pattern of uveitis in a referral ophthalmology center in Northeastern Thailand. J Ophthalmic Inflamm Infect 2024; 14:23. [PMID: 38819497 PMCID: PMC11143084 DOI: 10.1186/s12348-024-00400-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/18/2024] [Indexed: 06/01/2024] Open
Abstract
PURPOSE To report the characteristics and epidemiology of uveitis in a university-based referral center in northeastern Thailand and review the uveitis patterns present in various regions worldwide. METHODS A retrospective review of all medical records for new patients visiting the uveitis clinic at Srinagarind hospital, Khon Kaen University, between August 2016 and June 2021, was conducted. RESULTS A total of 522 uveitis patients were included in this study. Disease etiologies were categorized as non-infectious 35.8% (187/522), infectious 32.8% (171/522), and undetermined cause 31.4% (164/522). Specific diagnoses were established in 68.6% of cases. Vogt-Koyanagi-Harada (VKH) (14.2%) was identified as the most common specific diagnosis, and tuberculosis (6.7%) ranked highest among infectious causes. CONCLUSIONS Although non-infectious uveitis is observed predominantly in this region, the proportion of infectious uveitis is relatively more common than in developed countries. We have found no cause for one-third of our patients despite the utilization of PCR and serology for diagnostic purposes.
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Affiliation(s)
- Trakanta Wannapanich
- Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Waraporn Chuenchaem
- Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Wipada Laovirojjanakul
- Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
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Kalogeropoulos D, Asproudis I, Stefaniotou M, Moschos MM, Kozobolis VP, Voulgari PV, Katsanos A, Gartzonika C, Kalogeropoulos C. The large Hellenic Study of Uveitis: epidemiology, etiologic factors and classification. Int Ophthalmol 2023; 43:3633-3650. [PMID: 37428299 PMCID: PMC10504180 DOI: 10.1007/s10792-023-02772-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/22/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE To analyse the demography, etiology, and classification of uveitis at a tertiary academic referral center. METHODS An observational study was conducted on the archives of uveitic patients at the Ocular Inflammation Service of the Department of Ophthalmology at the University Hospital of Ioannina (Greece) from 1991 to 2020. This study aimed to investigate the epidemiological profile of patients, including their demographics and the main etiologic factors of uveitis. RESULTS Out of 6191 cases with uveitis, 1925 were infectious, 4125 were non-infectious, and an overall of 141 masquerade syndromes were recorded. Among these cases, 5950 patients were adults, with a slight female predominance, while 241 were children (< 18 years old). Interestingly, 24.2% of cases (1500 patients) were associated with 4 specific microorganisms. Herpetic uveitis (HSV-1 and VZV/HZV) was the most common cause of infectious uveitis (14.87%), followed by toxoplasmosis (6.6%) and tuberculosis (2.74%). In 49.2% of non-infectious uveitis cases, no systematic correlation was found. The most frequent causes of non-infectious uveitis included sarcoidosis, white dot syndromes, ankylosing spondylitis, lens-induced uveitis, Adamantiades-Behçet disease, and idiopathic juvenile arthritis. Infectious uveitis was more common in the rural population, whereas non-infectious uveitis was more frequently recorded in the urban population CONCLUSIONS: Although our study was conducted on a predominantly white Caucasian population, it also reflects the effect of increasing immigration, improvements of diagnostic techniques, changes in referral patterns, and various actual changes in disease incidence.
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Affiliation(s)
- Dimitrios Kalogeropoulos
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 451 10, Ioannina, Greece.
| | - Ioannis Asproudis
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 451 10, Ioannina, Greece
| | - Maria Stefaniotou
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 451 10, Ioannina, Greece
| | - Marilita M Moschos
- 1st Department of Ophthalmology, General Hospital of Athens G. Gennimatas, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vassilios P Kozobolis
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
| | - Paraskevi V Voulgari
- Department of Rheumatology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Andreas Katsanos
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 451 10, Ioannina, Greece
| | - Constantina Gartzonika
- Laboratory of Microbiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Chris Kalogeropoulos
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, University Campus, 451 10, Ioannina, Greece
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Long-term visual acuity outcome of pediatric uveitis patients presenting with severe visual impairment. Sci Rep 2023; 13:2919. [PMID: 36807333 PMCID: PMC9941571 DOI: 10.1038/s41598-023-29159-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/31/2023] [Indexed: 02/22/2023] Open
Abstract
This study investigated the long-term visual acuity (VA) outcome in the eyes of children with uveitis and severe visual impairment (SVI; VA ≤ 20/200) at presentation. Fifty-one children [57 eyes; median age, 11 years; 51% female; median follow-up period, 36 months (interquartile range 14.9-64.4)] aged ≤ 16 years with uveitis managed at our tertiary center from January 2010 to July 2020 were reviewed. Uveitis mainly manifested as unilateral (74.5%), chronic course (82.4%), and panuveitis (43.1%). Ocular toxoplasmosis and toxocariasis were the most common diagnoses (9.8% each). At least one ocular complication at presentation was observed in 93% of the eyes. Overall, the mean logMAR VA improved from 1.8 at presentation to 1.2 at 5 years (P < 0.001). Common causes of poor vision included retinal detachment, atrophic bulbi, and optic atrophy. Predictive factors associated with less VA improvement over the follow-up period included preschool age of uveitis onset (P < 0.001), ocular symptoms duration before uveitis diagnosis ≥ 1 month (P = 0.004), and non-anterior uveitis (P = 0.047). The long-term VA outcome in uveitis-affected eyes with SVI at presentation was unfavorable. Younger age at uveitis onset, delayed presentation, and uveitis involving the posterior segment were associated with poorer VA outcome.
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Seepongphun U, Sittivarakul W, Dangboon W, Chotipanvithayakul R. The Pattern of Uveitis in a Pediatric Population at a Tertiary Center in Thailand. Ocul Immunol Inflamm 2023; 31:56-64. [PMID: 34686121 DOI: 10.1080/09273948.2021.1980814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE To describe the clinical characteristics and longitudinal pattern of visual acuity (VA) of pediatric patients with uveitis at a tertiary center in Thailand. METHODS We retrospectively reviewed the records of children with uveitis ≤16 years who presented to the clinic between January 2010 and June 2020. RESULTS The mean age at onset was 9.1(±4.3) years; the main characteristics were chronic (64.4%), unilateral (68.6%), and panuveitis (39%). The common etiologies were ocular toxoplasmosis (11.9%), herpetic uveitis (10.2%), and ocular toxocariasis (6.8%). Further, 40% of the eyes presented with VA of ≤20/200; mean VA at baseline improved from 0.93 to 0.72 logMAR at 3 months after presentation (P < .001), the baseline VA of ≤20/200 was significantly associated with poor VA outcome at 1 year. CONCLUSION Chronic, unilateral, and panuveitis represented the majority of our children with uveitis. Infectious etiology was common. Significant VA improvement can be achieved with optimum management.
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Affiliation(s)
- Usanee Seepongphun
- Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Wantanee Sittivarakul
- Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Wantanee Dangboon
- Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Juhong J, Pongpirul K, Ueathaweephol S, Somkijrungroj T, Kongwattananon W. The patterns of uveitis and the factors affecting visual outcome from Chulalongkorn University Uveitis Cohort (CU2C): A 5-year longitudinal study protocol. PLoS One 2022; 17:e0275666. [PMID: 36201551 PMCID: PMC9536563 DOI: 10.1371/journal.pone.0275666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/21/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND In Thailand, several novel laboratory investigations are recently available to help differentiate the uveitic etiologies. The update on uveitis epidemiological data in Thailand is necessary to better understand the disease burden and provide guidance on management. The current study aims to describe the prevalence and identify factors associated with poor visual outcomes of uveitis patients at a tertiary center in Thailand. METHODS A 5-year-prospective study of uveitis cases presented at a tertiary referral center in the central region of Thailand is conducted.
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Affiliation(s)
- Jakkrit Juhong
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Krit Pongpirul
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Thanapong Somkijrungroj
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Retina, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Wijak Kongwattananon
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Retina, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- * E-mail:
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Alli HD, Ally N, Mayet I, Dangor Z, Madhi SA. Global prevalence and clinical outcomes of tubercular uveitis: a systematic review and meta-analysis. Surv Ophthalmol 2021; 67:770-792. [PMID: 34626620 DOI: 10.1016/j.survophthal.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 11/16/2022]
Abstract
Tubercular uveitis (TBU) is an inflammation/infection of the eye secondary to Mycobacterium tuberculosis infection. The difficulty in making the diagnosis has resulted in variable prevalence and clinical response rates. We aimed to determine the global prevalence of TBU in uveitis patients stratified by TB high-burden countries (HBCs) and non-HBCs and by geographic regions and the clinical response of TBU to antitubercular treatment We performed a systematic review and meta-analysis of TBU studies published in PubMed, Scopus and EMBASE, up to June 30, 2020. A random effects model was used for all meta-analyses. Of 5,018 articles identified, 70 prevalence studies (65,607 uveitis and 3,166 TBU cases) and 18 clinical outcome studies (1,570 TBU cases; 1,304 responded to anti-tubercular therapy [ATT]) were analyzed. The overall weighted prevalence of TBU was 4.0% (95% CI, 3-5); in TB HBCs it was 7.0% (95% CI, 5-11), non-HBCs 3.0% (95% CI, 2-4), and sub-Saharan Africa 11.0% (95% CI, 8-15). The overall weighted clinical response was 82.0% (95% CI, 75-89). Despite the difficulty in diagnosing TBU, the prevalence is expectantly higher in HBCs, and sub-Saharan Africa and the clinical outcome is poor. Standardization of diagnostic criteria and ATT is warranted in future cohort studies.
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Affiliation(s)
- Hassan D Alli
- Division of Ophthalmology, St John Eye Hospital/Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, South Africa.
| | - Naseer Ally
- Division of Ophthalmology, St John Eye Hospital/Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Ismail Mayet
- Division of Ophthalmology, St John Eye Hospital/Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Ziyaad Dangor
- Department of Pediatrics, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Shabir A Madhi
- Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit (VIDA), Faculty of Health Sciences, University of the Witwatersrand, South Africa
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Ryumin AM, Pavlova AA, Otmahova IA, Khryaeva OL. [Acute retinal necrosis caused by varicella zoster virus]. Vestn Oftalmol 2020; 136:236-241. [PMID: 33371655 DOI: 10.17116/oftalma2020136062236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Incidence of Herpes Zoster is relatively high. Herpes zoster ophthalmicus is one of the most common forms of the disease. Necrotising herpetic retinopathies (including acute retinal necrosis) are rare and usually these complications are presented in literature as individual cases. However, necrotising herpetic retinopathy can lead to complete loss of visual. The article reviews modern data on causation, diagnosis and treatment of acute retinal necrosis analyzing 40 open access articles from EBSCO published in 2011-2019, and describes the modern views on the prevalence and most important clinical features of herpetic acute retinal necrosis. Some contradictory opinions have been revealed concerning the diagnostic criteria and surgical treatment of acute retinal necrosis.
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Affiliation(s)
- A M Ryumin
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - A A Pavlova
- City Hospital No 35, Nizhny Novgorod, Russia
| | - I A Otmahova
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - O L Khryaeva
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
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8
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Louthrenoo W, Kasitanon N, Pathanapitoon K, Wangkaew S, Kuwata S, Nishi A, Kaburaki T, Tanaka R, Takeuchi F. Contribution of HLA-B*51:01 and -A*26:01 to Behçet's disease and their clinical association in Thai patients. Int J Rheum Dis 2020; 23:247-255. [PMID: 31944588 DOI: 10.1111/1756-185x.13785] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/30/2019] [Accepted: 12/16/2019] [Indexed: 11/29/2022]
Abstract
AIMS To investigate susceptible human leukocyte antigen (HLA) alleles and their associations with clinical features in Thai patients with Behçet's disease (BD). METHOD Eighteen HLA-A and 36 HLA-B alleles were determined in 42 Thai BD patients and 99 healthy controls (HCs) by reverse line blot assay, and reconfirmed by MICRO SSP assay. RESULTS The BD patients had significantly higher allele frequency (AF) of HLA-B*51 than the HCs (13.10% vs 5.05%, P = .025). The AF of HLA-A*26, -A*26:01 and -B*51:01 also was higher and almost reached statistical significance (5.59% vs 1.52%, P = .054, 5.95% vs 1.52%, P = .054 and 10.71% vs 4.04%, P = .051, respectively). However, the BD patients had significantly higher AF of either HLA-A*26:01 or -B*51:01 (16.67% vs 5.56%, P = .005), or -A*26:01 or -B*51X (19.05% vs 6.56%, P = .003). The AF of HLA-B*51:01 and -B*51X increased significantly in -A*26:01 non-carrier BD patients (12.16% vs 4.17%, P = .024 and 14.86% vs 5.21%, P = .019, respectively); and that of HLA-A*26:01 was significantly higher in -B*51X non-carrier BD patients (7.58% vs 1.67%, P = .034). HLA-B*51:01 associated significantly with the presence of posterior uveitis and visual impairment (18.18% vs 2.50%, P = .031 for both conditions). HLA-B*51:01 was not observed in BD patients with gastrointestinal involvement or arthritis. Furthermore, the AF of HLA-B*51:01 was significantly higher in HLA-A*26:01 non-carrier BD patients without arthritis (17.30% vs 0%, P = .050). CONCLUSION HLA-B*51:01 was a susceptible allele for Thai BD patients, and associated with posterior uveitis and visual impairment. HLA-A*26:01 was another susceptible allele in HLA-B*51X non-carrier patients. The protective effect of HLA-B*51:01 on arthritis needs further investigation.
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Affiliation(s)
- Worawit Louthrenoo
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nuntana Kasitanon
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kessara Pathanapitoon
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Suparaporn Wangkaew
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Shoji Kuwata
- Department of Internal Medicine, Faculty of Medicine, Teikyo University School of Medicine, Ichihara, Japan
| | - Ai Nishi
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Toshikatsu Kaburaki
- Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Rie Tanaka
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Fujio Takeuchi
- Department of Internal Medicine (Allergy and Rheumatology), Faculty of Medicine, University of Tokyo, Tokyo, Japan
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Abstract
Serpiginous choroiditis (SC) is an asymmetrically bilateral inflammation of the choroid that leads to loss of choriocapillaris atrophy or loss of overlying retinal pigment epithelium. Over the last few decades, SC has passed through a long evolution of nomenclature, etiologies and morphological variations. Initially diagnosed in patients with tuberculosis and syphilis, SC was predominantly considered as autoimmune process. With the advancement of molecular diagnosis, a new aspect of infectious subtypes of SC has emerged out. The terminologies such as serpiginous-like choroiditis (SLC) and multifocal serpiginoid choroiditis are now used to denote the subtypes of SC which are associated with infectious etiologies especially tuberculosis. In a country endemic for tuberculosis such as India, it is very important to differentiate between classic SC and SLC before initiating aggressive immunomodulatory therapy. Also, management of paradoxical worsening of the clinical condition with antitubercular treatment is another challenge in SLC and ophthalmologists should be aware of such situations. With advent of newer imaging modalities, monitoring the patient with choroiditis and identification of complications such as choroidal neovascular membrane have become much easier. This article aims to review the existing literature on SC with a special emphasis on management of SC and SLC.
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Affiliation(s)
| | - Jyotirmay Biswas
- Department of Uvea and Department of Larsen and Toubro Ocular Pathology, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Amod Gupta
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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10
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Keorochana N. Pattern and Outcome of Uveitis in a Tertiary Military Hospital in Thailand. Ocul Immunol Inflamm 2019; 28:424-432. [DOI: 10.1080/09273948.2019.1589527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Narumon Keorochana
- Ocular inflammation and infection division, Department of Ophthalmology, Phramongkutklao hospital, Phramongkutklao college of Medicine, Bangkok, Thailand
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Hsu YR, Huang JCC, Tao Y, Kaburaki T, Lee CS, Lin TC, Hsu CC, Chiou SH, Hwang DK. Noninfectious uveitis in the Asia-Pacific region. Eye (Lond) 2018; 33:66-77. [PMID: 30323327 DOI: 10.1038/s41433-018-0223-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 08/19/2018] [Accepted: 08/23/2018] [Indexed: 12/19/2022] Open
Abstract
Uveitis is a sight-threatening disease. Up to 35% of patients may have impaired vision. Inflammation of the uvea tissue has more than 60 etiologies. Previous reports have shown that 20-40% of uveitis cases were noninfectious. Some of them may be associated with systemic rheumatological and autoimmune diseases but some may affect the eyes only. The epidemiology and clinical situations of some specific uveitis entities vary worldwide because they are influenced by genetic, ethnic, environmental, and socioeconomic factors. The Asia-Pacific region comprises more than 30 countries. Epidemiology and patterns of uveitis vary greatly in this region. However, some uveitis entities, such as Behcet's disease, sarcoidosis, and Vogt-Koyanagi-Harada disease, are more common in this region. Many studies on the epidemiology, risk factors, and immune pathogenesis of this disease have been conducted. In this article, we review the epidemiology of noninfectious uveitis and special situations of these three uveitis entities in the Asia-Pacific region.
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Affiliation(s)
- Yung-Ray Hsu
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Department of Ophthalmology, National Taiwan University, Taipei, Taiwan
| | | | - Yong Tao
- Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Toshikatsu Kaburaki
- Department of Ophthalmology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Christopher Seungkyu Lee
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
| | - Tai-Chi Lin
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chih-Chien Hsu
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Hwa Chiou
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan. .,Department of Medical Research & Education, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - De-Kuang Hwang
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan. .,School of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
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Luca C, Raffaella A, Sylvia M, Valentina M, Fabiana V, Marco C, Annamaria S, Luisa S, Alessandro DF, Lucia B, Alessandro Z, Maria P, Matthew C, Alessandra S, Carlo S, Luigi F. Changes in patterns of uveitis at a tertiary referral center in Northern Italy: analysis of 990 consecutive cases. Int Ophthalmol 2018; 38:133-142. [PMID: 28070744 PMCID: PMC5876414 DOI: 10.1007/s10792-016-0434-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 12/27/2016] [Indexed: 12/19/2022]
Abstract
PURPOSE The role of uveitis, an uncommon ocular disease, is often neglected in research and treatment of autoimmune conditions. The study described the spectrum of uveitis at a referral center in North Italy, and compared that to a previously published series of patients. METHODS We reviewed all patients with uveitis diagnosed from 2013 to 2015 at the Immunology Eye Unit, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy. We examined patient characteristics, disease spectrum, and etiologies. RESULTS In total, 990 cases of uveitis were identified, who were mostly female (59%) with a median age at presentation of 44 years (interquartile range = 29-57). Anterior uveitis was most frequent (53.5%), followed by panuveitis (22.8%), posterior (16.2%), and intermediate uveitis (5.5%). Anterior herpetic uveitis (15.6%), Fuchs uveitis (9.7%), and HLA-B27 positive anterior uveitis (7.7%) were the most common specific diagnoses. Compared with the previous series, we observed an increased incidence of uveitis, and a different pattern of diagnoses. Rates of herpetic, HLA-B27 positive uveitis, and presumed ocular tuberculosis were higher, but Fuchs uveitis was less frequent. CONCLUSIONS The pattern of uveitis appears to be changing, very likely due to population-level increases in infectious diseases, to the availability of new diagnostic tests and to the interdisciplinary approach used in patient diagnosis.
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Affiliation(s)
- Cimino Luca
- Immunology Eye Unit, Eye Department, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy
| | - Aldigeri Raffaella
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Marchi Sylvia
- Immunology Eye Unit, Eye Department, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy
- Eye Department, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy
| | - Mastrofilippo Valentina
- Immunology Eye Unit, Eye Department, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy
- Eye Department, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy
| | - Viscogliosi Fabiana
- Immunology Eye Unit, Eye Department, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy
| | - Coassin Marco
- Eye Department, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy
| | - Soldani Annamaria
- Immunology Eye Unit, Eye Department, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy
- Eye Department, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy
| | - Savoldi Luisa
- Scientific Directorate, Arcispedale S.M. Nuova-IRCCS, Reggio Emilia, Italy
| | - De Fanti Alessandro
- Department of Pediatrics, Arcispedale S. M. Nuova.IRCCS, Reggio Emilia, Italy
| | - Belloni Lucia
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Zerbini Alessandro
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Parmeggiani Maria
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Chersich Matthew
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Soriano Alessandra
- Rheumatology Unit, Department of Internal Medicine, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy
| | - Salvarani Carlo
- Rheumatology Unit, Department of Internal Medicine, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy
| | - Fontana Luigi
- Eye Department, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy
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Okafor LO, Hewins P, Murray PI, Denniston AK. Tubulointerstitial nephritis and uveitis (TINU) syndrome: a systematic review of its epidemiology, demographics and risk factors. Orphanet J Rare Dis 2017; 12:128. [PMID: 28709457 PMCID: PMC5513333 DOI: 10.1186/s13023-017-0677-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 06/19/2017] [Indexed: 01/22/2023] Open
Abstract
Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare oculorenal inflammatory condition that was first described in 1975. In 2001 a major review identified 133 cases in the world literature and proposed key diagnostic criteria for the condition. Although acknowledged as rare, the limited data available prevented reliable estimates of the prevalence of the condition, and hampered elucidation of the relationship between genetic and environmental factors that contribute to its pathogenesis.In this review we have performed a systematic search on the epidemiology, demographics and proposed risk factors for TINU. Estimates of prevalence based on studies that explicitly report TINU cases suggest that it is diagnosed in 0.2-2% of patients attending specialist uveitis services, with variation reflecting a number of factors including level of diagnostic certainty required. The prevalence of uveitis in patients with tubulointerstitial nephritis (TIN) may be higher than currently recognised, particularly in the paediatric population.The prevalence of TINU is higher in younger age groups and there is a female preponderance although this gender effect appears weaker than suggested by early studies. Although important genetic contributions have been proposed, the small size of studies and variation between reports currently preclude identification of a 'pro-TINU' haplotype. Drugs and infections have been proposed as the leading acquired risk factors for the development of TINU; whilst the small size of TINU cohorts and issues of study design limit interpretation of many studies. Larger datasets from the renal literature suggest that the majority of these cases are precipitated by a drug-induced hypersensitivity reaction; however in many ophthalmic cases no clear precipitant is identified.
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Affiliation(s)
- Linda O. Okafor
- Department of Ophthalmology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Birmingham & Midland Eye Centre, Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Peter Hewins
- Department of Renal Medicine, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Translational Medicine, Centre for Rare Diseases, Birmingham Health Partners, Birmingham, UK
| | - Philip I. Murray
- Birmingham & Midland Eye Centre, Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, UK
- Institute of Inflammation and Ageing, Academic Unit of Ophthalmology, University of Birmingham, Birmingham, B15 2WB UK
| | - Alastair K. Denniston
- Department of Ophthalmology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Translational Medicine, Centre for Rare Diseases, Birmingham Health Partners, Birmingham, UK
- Institute of Inflammation and Ageing, Academic Unit of Ophthalmology, University of Birmingham, Birmingham, B15 2WB UK
- NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
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Tesavibul N, Boonsopon S, Choopong P, Tanterdtham S. Uveitis in Siriraj Hospital: pattern differences between immune-related uveitis and infectious uveitis in a university-based tertiary care hospital. Int Ophthalmol 2017; 38:673-678. [PMID: 28429127 DOI: 10.1007/s10792-017-0515-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 04/04/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE To describe a proportion of uveitis and to analyse differences between immune-related uveitis and infectious uveitis groups. METHODS A retrospective study of 458 uveitis patients were categorized into immune-related uveitis, infectious uveitis, masquerade, and undetermined groups. The pattern of inflammation was described. Subgroup analysis was performed to compare pattern differences between immune-related uveitis and infectious uveitis groups. RESULTS The most common location of inflammation was the anterior eye segment. Vogt-Koyanagi-Harada disease was the most common identifiable cause. From multivariate analysis, variables found to be significantly different between immune-related uveitis group and infectious uveitis group were age of onset, presence of systemic autoimmune diseases, HIV infection, and laterality. CONCLUSIONS Idiopathic anterior uveitis was the most prevalent diagnosis. Vogt-Koyanagi-Harada disease was the most common identifiable uveitis. Most immune-related uveitis patients were young and presented with chronic bilateral panuveitis, with most patients in the infectious uveitis group presenting with chronic unilateral posterior uveitis.
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Affiliation(s)
- Nattaporn Tesavibul
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.
| | - Sutasinee Boonsopon
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
| | - Pitipol Choopong
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
| | - Sujintana Tanterdtham
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.,Department of Ophthalmology, Nakornpathom Hospital, 196 Tesa 7 Road, Prapathomchedi, Muang, Nakornpathom, 73000, Thailand
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Chee SP, Khairallah M. Global Variations and Changes in Patterns of Infectious Uveitis. EMERGING INFECTIOUS UVEITIS 2017. [PMCID: PMC7115009 DOI: 10.1007/978-3-319-23416-8_1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Before 1940, most uveitis cases were supposed to be due to infectious agents, mainly syphilis or tuberculosis [1]. Progress in the understanding of intraocular inflammation led to the discovery that uveitis can be of infectious and noninfectious origin and that many pathogens can cause infectious uveitis. Theoretically, Koch postulates must be fulfilled, in order to formerly demonstrate that a disease is due to an infectious agent. However, in infectious uveitis, most often, serological evidence, molecular or histological demonstration, and treatment response are usually the only available elements to suggest the infectious origin of the uveitis. Using those evidences, a large number of infectious organisms have been demonstrated to cause infectious uveitis. Some have a global importance around the world, while others have more limited niches. Many of them have been considered as emerging pathogens.
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Affiliation(s)
| | - Moncef Khairallah
- Department of Ophthalmology, Fattouma Bourguiba University Hospital, Faculty of Medicine, Monastir, Tunisia
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Chen EJ, Bin Ismail MA, Mi H, Ho SL, Lim WK, Teoh SC, Agrawal R. Ocular Autoimmune Systemic Inflammatory Infectious Study (OASIS) - Report 1: Epidemiology and Classification. Ocul Immunol Inflamm 2016; 26:732-746. [PMID: 27918224 DOI: 10.1080/09273948.2016.1249376] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE To report the epidemiology and classification of ocular inflammation at a tertiary eye care center in Singapore. METHODS Retrospective cohort study of the clinical records of consecutive new cases from the Ocular Autoimmune Systemic Inflammatory Infectious Study (OASIS) database from 2004-2015. RESULTS A total of 2200 patients were studied from the OASIS database. The most common anatomic diagnosis was anterior uveitis (55.9%), posterior uveitis (17.5%), panuveitis (9.6%), and intermediate uveitis (4.7%). In addition, scleritis (6.1%), keratouveitis (2.8%), retinal vasculitis (2.2%), and episcleritis (1.2%) were observed. Etiology was established in 65.1%, with 35.2% of patients associated with non-infectious etiologies. The most common etiologies found were presumed tuberculosis (7.2%), followed by cytomegalovirus infection (6.9%), herpetic infection (6.3%), HLA-B27-associated anterior uveitis (4.2%), and ankylosing spondylitis (3.8%). CONCLUSIONS The pattern of ocular inflammation in Singapore has similarities with both Western and Asian populations. Anterior uveitis was the most common, with non-infectious etiologies being slightly more common than infectious etiologies.
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Affiliation(s)
- Elizabeth J Chen
- a Yong Loo Lin School of Medicine , National University of Singapore , Singapore
| | | | - Helen Mi
- b National Healthcare Group Eye Institute , Tan Tock Seng Hospital , Singapore
| | - Su Ling Ho
- b National Healthcare Group Eye Institute , Tan Tock Seng Hospital , Singapore
| | - Wee Kiak Lim
- b National Healthcare Group Eye Institute , Tan Tock Seng Hospital , Singapore.,c Eagle Eye Center , Mount Elizabeth Novena Hospital , Singapore
| | - Stephen C Teoh
- b National Healthcare Group Eye Institute , Tan Tock Seng Hospital , Singapore.,c Eagle Eye Center , Mount Elizabeth Novena Hospital , Singapore
| | - Rupesh Agrawal
- a Yong Loo Lin School of Medicine , National University of Singapore , Singapore.,b National Healthcare Group Eye Institute , Tan Tock Seng Hospital , Singapore
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Yalçındağ FN, Özdal PC, Özyazgan Y, Batıoğlu F, Tugal-Tutkun I. Demographic and Clinical Characteristics of Uveitis in Turkey: The First National Registry Report. Ocul Immunol Inflamm 2016; 26:17-26. [PMID: 27467500 DOI: 10.1080/09273948.2016.1196714] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To describe the demographic and clinical profiles of uveitis patients seen at secondary and tertiary care centers in Turkey. METHODS A nationwide web-based registry of patients with uveitis was initiated in November 2008. We analyzed data from a single baseline registry-enrollment visit. RESULTS In 33 centers, 6967 eyes of 4863 consecutive patients were registered. The mean age at presentation was 36.6 ± 15.7 (1-92) years; 51.3% were male. Behçet disease was the leading diagnosis (24.9%), followed by ankylosing spondylitis and/or HLA-B27-associated anterior uveitis (9.7%), toxoplasmosis (7.1%), Fuchs uveitis (6.3%), and presumed herpetic anterior uveitis (6.0%). Visual acuity was 0.1 or worse in 22% of eyes. The most common ocular complications were posterior synechiae (16.2%) and cataract formation (16.2%). CONCLUSIONS Behçet disease is still the most common non-infectious etiology in Turkish uveitis patients, while ocular toxoplasmosis and herpetic anterior uveitis are the most common infectious uveitic entities.
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Affiliation(s)
- F Nilüfer Yalçındağ
- a Department of Ophthalmology , Ankara University, Faculty of Medicine , Ankara , Turkey
| | - Pınar C Özdal
- b Ulucanlar Eye Research and Training Hospital , Ankara , Turkey
| | - Yılmaz Özyazgan
- c Department of Ophthalmology , Istanbul University, Cerrahpasa Faculty of Medicine , Istanbul , Turkey
| | - Figen Batıoğlu
- a Department of Ophthalmology , Ankara University, Faculty of Medicine , Ankara , Turkey
| | - Ilknur Tugal-Tutkun
- d Department of Ophthalmology , Istanbul University, Istanbul Faculty of Medicine , Istanbul , Turkey
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Pathanapitoon K, Dodds EM, Cunningham ET, Rothova A. Clinical Spectrum of HLA-B27-associated Ocular Inflammation. Ocul Immunol Inflamm 2016; 25:569-576. [DOI: 10.1080/09273948.2016.1185527] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
| | - Emilio M. Dodds
- Consultores Oftalmológicos, Hospital Juan A. Fernández, Buenos Aires, Argentina
| | - Emmett T. Cunningham
- The Department of Ophthalmology, California Pacific Medical Center, San Francisco, California, USA
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, California, USA
- The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, California, USA
- West Coast Retina Medical Group, San Francisco, California, USA
| | - Aniki Rothova
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
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Nakahara H, Kaburaki T, Tanaka R, Takamoto M, Ohtomo K, Karakawa A, Komae K, Okinaga K, Matsuda J, Fujino Y. Frequency of Uveitis in the Central Tokyo Area (2010–2012). Ocul Immunol Inflamm 2016; 25:S8-S14. [DOI: 10.3109/09273948.2015.1133840] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Hisae Nakahara
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Toshikatsu Kaburaki
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Rie Tanaka
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Mitsuko Takamoto
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Kazuyoshi Ohtomo
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Ayako Karakawa
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Keiko Komae
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Kimiko Okinaga
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Junko Matsuda
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Yujiro Fujino
- Department of Ophthalmology, Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Shinjuku-ku, Tokyo, Japan
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Bajwa A, Osmanzada D, Osmanzada S, Khan I, Patrie J, Xin W, Reddy AK. Epidemiology of uveitis in the mid-Atlantic United States. Clin Ophthalmol 2015; 9:889-901. [PMID: 26056428 PMCID: PMC4445955 DOI: 10.2147/opth.s80972] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To demonstrate the demographic, anatomic, and diagnostic classification of patients with uveitis seen in a tertiary care center in central Virginia. METHODS Retrospective chart review of patient demographics, disease characteristics, and disease severity-related outcomes (therapies, visual outcomes, and complications) from 1984 to 2014. RESULTS There were 491 patients (644 eyes) with mean age of 46 years (±21.4 years) and mean duration of follow up of 4.8 years (±6.8 years). Of these, 278 patients were female (56.6%). Further, 60.5% were Caucasian, and 27.3% were African American. The anatomic types seen were anterior uveitis (67.3%), panuveitis (14.5%), posterior uveitis (12.6%), and intermediate uveitis (5.3%). The most common etiology was post-traumatic (12.2%), followed by post-procedural (10.0%), herpetic (7.9%), human leukocyte antigen (HLA)-B27-associated (6.7%), and sarcoidosis (6.7%). Herpetic uveitis was more common among Caucasians than African Americans (sex-adjusted odds ratio [OR]: 7.69, 95% confidence interval [CI] [2.12, 50.00]), and sarcoidosis was more common among African Americans than Caucasians (sex-adjusted OR: 6.54, 95% CI [2.98, 15.29]). Herpetic anterior uveitis was more common among females than males (race-adjusted OR: 3.03, 95% CI [1.32, 7.71]). Multifocal choroiditis was more common among males than females (race-adjusted OR: 9.09, 95% CI [1.47, 100.00]). Mean logMAR visual acuity was 0.18 at initial and final visit. A total 388 (79%) and 133 (27.3%) patients received local and systemic steroids, respectively. A total 52 patients (10.6%) received an antimetabolite. A total 116 patients (23.7%) were managed with topical glaucoma medication. A total 43 (8.8%), 129 (26.4%), and 46 patients (9.4%) underwent glaucoma surgery, cataract surgery, and vitrectomy, respectively. CONCLUSION Over the period of this study, Caucasian patients were more frequently seen than non-Caucasians, although African Americans constituted a considerable size of study population. The most common diagnoses were undifferentiated anterior uveitis, traumatic uveitis, post-procedural uveitis, herpetic disease, HLA-B27 associated uveitis, and sarcoidosis. Unlike previous reports, traumatic and post-procedural uveitis were frequently reported. Mean visual acuity remained stable from initial to final visit.
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Affiliation(s)
- Asima Bajwa
- Department of Ophthalmology, University of Virginia, Charlottesville, VA, USA
| | - Diba Osmanzada
- Department of Ophthalmology, University of Virginia, Charlottesville, VA, USA
| | - Susan Osmanzada
- Department of Ophthalmology, University of Virginia, Charlottesville, VA, USA
| | - Irfan Khan
- Department of Ophthalmology, University of Virginia, Charlottesville, VA, USA
| | - Jim Patrie
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Wenjun Xin
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Ashvini K Reddy
- Department of Ophthalmology, University of Virginia, Charlottesville, VA, USA
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Zheng Y, Zhang LX, Meng QL, Zhang M, Cui Y, Liu QY, Luo ZL, Du LP. Clinical patterns and characteristics of uveitis in a secondary hospital in southern China. Int J Ophthalmol 2015; 8:337-41. [PMID: 25938052 PMCID: PMC4413584 DOI: 10.3980/j.issn.2222-3959.2015.02.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 09/24/2014] [Indexed: 11/02/2022] Open
Abstract
AIM To investigate the characteristics of uveitis in a secondary hospital in southern China. METHODS We reviewed all records of patients with uveitis at Hengli Hospital from January 2008 to December 2011. Demographic data, past history, ophthalmic examinations and other laboratory tests were analyzed. RESULTS One hundred and ninety-nine uveitis patients were enrolled in this study, including 134 (67.3%) males and 65 females (32.7%) with an average age of 41.0±15.1y. The anatomical distribution included 103 (51.8%) cases of anterior uveitis, followed by panuveitis (65, 32.7%), posterior uveitis (29, 14.6%) and intermediate uveitis (2, 1.0%). Of the 98 (49.2%) non-idiopathic cases, there were 10.1% Behcet's disease, 9.5% Vogt-Koyanagi-Harada (VKH) syndrome, 7.5%infectious uveitis, 7.5% traumatic uveitis and 3.5% postoperative uveitis. CONCLUSION Idiopathic anterior and posterior uveitis, Behcet's disease, VKH syndrome, infectious uveitis and traumatic uveitis are the most common uveitis entities in a secondary hospital in southern China. Additional measures should be taken to prevent infectious and traumatic uveitis.
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Affiliation(s)
- Yang Zheng
- Chongqing Eye Institute, Chongqing Key Laboratory of Ophthalmology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Li-Xin Zhang
- Hengli Town People's Hospital, Dongguan 523460, Guangdong Province, China
| | - Qian-Li Meng
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China
| | - Min Zhang
- Department of Ophthalmology, Dongguan People's Hospital, Dongguan 523018, Guangdong Province, China
| | - Ying Cui
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong Province, China
| | - Qing-Yang Liu
- Department of Ophthalmology, Dongguan People's Hospital, Dongguan 523018, Guangdong Province, China
| | - Zhong-Ling Luo
- Hengli Town People's Hospital, Dongguan 523460, Guangdong Province, China
| | - Li-Ping Du
- Chongqing Eye Institute, Chongqing Key Laboratory of Ophthalmology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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Grajewski RS, Caramoy A, Frank KF, Rubbert-Roth A, Fätkenheuer G, Kirchhof B, Cursiefen C, Heindl LM. Spectrum of Uveitis in A German Tertiary Center: Review of 474 Consecutive Patients. Ocul Immunol Inflamm 2015; 23:346-352. [PMID: 25760917 DOI: 10.3109/09273948.2014.1002567] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To analyze the spectrum of uveitis at a German tertiary center. PATIENTS AND METHODS A total of 474 consecutive patients with uveitis were classified according to the primary anatomic site of inflammation, examined for laterality of disease, and screened for etiologies. RESULTS Out of the total, 253 patients (53%) had anterior uveitis, 90 patients (19%) had intermediate uveitis, 100 patients (21%) had posterior uveitis, and 31 patients (7%) had panuveitis. Fifty-six percent of the patients had bilateral involvement, predominantly in intermediate uveitis (ratio 4:1) and panuveitis (ratio 3.4:1). Regarding the etiology of all uveitis cases we found 17% infectious, 23% specific clinical entities, 20% associated with systemic disease (most commonly sarcoidosis with 11%), and 41% idiopathic uveitis. CONCLUSIONS Anterior uveitis was the most common anatomic site of intraocular inflammation. Using a tailored approach, screening for systemic etiologies is recommended, since 20% of all patients had associated systemic diseases.
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Affiliation(s)
| | | | | | - Andrea Rubbert-Roth
- c Department of Internal Medicine I , University of Cologne , Cologne , Germany
| | - Gerd Fätkenheuer
- c Department of Internal Medicine I , University of Cologne , Cologne , Germany
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Nakahara H, Kaburaki T, Takamoto M, Okinaga K, Matsuda J, Konno Y, Kawashima H, Numaga J, Fujino Y, Amano S. Statistical analyses of Endogenous Uveitis Patients (2007–2009) in central Tokyo area and Comparison with Previous Studies (1963–2006). Ocul Immunol Inflamm 2014; 23:291-296. [DOI: 10.3109/09273948.2014.920036] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Silpa-archa S, Noonpradej S, Amphornphruet A. Pattern of Uveitis in a Referral Ophthalmology Center in the Central District of Thailand. Ocul Immunol Inflamm 2014; 23:320-328. [DOI: 10.3109/09273948.2014.943773] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Al Dhahri H, Al Rubaie K, Hemachandran S, Mousa A, Gikandi PW, Al-Mezaine HS, Abu El-Asrar AM. Patterns of Uveitis in a University-based Tertiary Referral Center in Riyadh, Saudi Arabia. Ocul Immunol Inflamm 2014; 23:311-319. [DOI: 10.3109/09273948.2014.939197] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Khochtali S, Abroug N, Kahloun R, Ksiaa I, Nahdi I, Zaouali S, Ben Yahia S, Khairallah M. Pattern of Acute Retinal Necrosis in a Referral Center in Tunisia, North Africa. Ocul Immunol Inflamm 2014; 23:371-7. [PMID: 24945738 DOI: 10.3109/09273948.2014.925125] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To describe the pattern of acute retinal necrosis (ARN) syndrome in a referral center in Tunisia. METHODS Retrospective review of the charts of 12 patients (12 eyes). RESULTS Necrotizing retinitis involved >50% of the retina in 33.3% of eyes. Polymerase chain reaction on aqueous humor sample identified herpes simplex virus-1 in 4 eyes (33.3%) and varicella zoster virus in 3 eyes (25%), and was negative in 5 eyes (41.7%). All patients received intravenous acyclovir, followed by oral antivirals. Follow-up ranged from 6 to 16 months. Retinal detachment (RD) occurred in 3 eyes (25%), but no patient developed bilateral ARN. Final visual acuity was 20/200 or worse in 7 eyes (58.3%). Delay in diagnosis (p = 0.015), macular involvement (p = 0.045), development of RD (p = 0.018), and 25-50% of retinal involvement (p = 0.045) were associated with a worse visual outcome. CONCLUSION ARN carries poor visual prognosis in Tunisia.
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Affiliation(s)
- Sana Khochtali
- a Department of Ophthalmology , Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir , Tunisia
| | - Nesrine Abroug
- a Department of Ophthalmology , Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir , Tunisia
| | - Rim Kahloun
- a Department of Ophthalmology , Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir , Tunisia
| | - Imen Ksiaa
- a Department of Ophthalmology , Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir , Tunisia
| | - Imen Nahdi
- a Department of Ophthalmology , Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir , Tunisia
| | - Sonia Zaouali
- a Department of Ophthalmology , Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir , Tunisia
| | - Salim Ben Yahia
- a Department of Ophthalmology , Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir , Tunisia
| | - Moncef Khairallah
- a Department of Ophthalmology , Fattouma Bourguiba University Hospital, Faculty of Medicine, University of Monastir , Monastir , Tunisia
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Jones NP. The Manchester Uveitis Clinic: The First 3000 Patients—Epidemiology and Casemix. Ocul Immunol Inflamm 2013; 23:118-26. [DOI: 10.3109/09273948.2013.855799] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Profil épidémiologique des uvéites dans la région de Tunis. J Fr Ophtalmol 2013; 36:764-8. [DOI: 10.1016/j.jfo.2013.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 04/23/2013] [Accepted: 05/17/2013] [Indexed: 11/19/2022]
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