A decade-long review: insights into diagnosis and disease evolution of uveitis from a single-center study
摘要
To analyse the evolution of uveitis diagnosis over a 10-year period, emphasizing the change in etiological diagnosis, and the factors associated with recurrences.
DesignRetrospective chart review.
MethodsA total of 15,000 patients with uveitis presented at our tertiary care institute in North India between 1992 and 2023. Of these,123 patients completed 10-year follow-up and were included in the study. The data of patients was collected on an offline purpose-built uveitis registry portal: Ocular Autoimmune Systemic Inflammatory and Infectious Study(OASIS).
ResultsThe study included 123 patients (48.78% males; mean age: 29.11 ± 15.22 years). The most common anatomical and etiological diagnosis at presentation were anterior (49/123,34.96%) and idiopathic(59/123,47.97%) uveitis respectively. At the end of 10 years, anterior uveitis remained the most common anatomical diagnosis (43/123,39.83%) while the most common etiological diagnosis was immune-mediated uveitis (50/123,40.65%). An etiological diagnosis could be established in 50.85% (30/59) of patients initially labelled as idiopathic. Tuberculous uveitis (39/44, 88.63%) and Juvenile Idiopathic Arthritis associated uveitis (16/49, 32.65%) were the commonest infectious and immune-mediated aetiologies at the 10-year follow-up. Ninety-six (80.67%) patients experienced multiple episodes of ocular inflammation with a mean recurrence rate of 0.386 ± 0.24 recurrences/year. Anterior uveitis (p = 0.01), the change in etiological diagnosis after the first year (p = 0.03), positive HLA-B27 at baseline (p = 0.04), and the diagnosis of a systemic disease prior to the onset of uveitis were associated with higher recurrences rates (p = 0.03).
ConclusionOver 10-year of follow-up, half of the uveitis diagnoses evolved from idiopathic to specific infectious or immune-mediated aetiologies. Our results indicate that patients with a high recurrence rate may benefit from re-evaluation to find the definitive cause of uveitis.