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Clinical patterns and visual outcomes of uveitis and its associated systemic diseases: a 10-year case series in China

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Abstract Number: 3853

AuthorBlock: Peizeng Yang1,6, Zhenyu Zhong1,6, Liping Du1,6, Fuzhen Li2, Hong Li1,6, Ke Hu1,6, Chaokui Wang1,6, Zi Ye1,6, Jian Qi1,6, Hongtao Dong2, Xinyu Li2, Quan Dong Nguyen5, Ying Han4, Aize Kijlstra3
1The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; 2The First Affiliated Hospital of Zhengzhou University, , China; 3University Eye Clinic Maastricht, , Netherlands; 4Department of Ophthalmology, University of California, San Francisco, California, United States; 5Byers Eye Institute, Stanford University, California, United States; 6Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, , China;

DisclosureBlock: Peizeng Yang, None; Zhenyu Zhong, None; Liping Du, None; Fuzhen Li, None; Hong Li, None; Ke Hu, None; Chaokui Wang, None; Zi Ye, None; Jian Qi, None; Hongtao Dong, None; Xinyu Li, None; Quan Dong Nguyen, None; Ying Han, None; Aize Kijlstra, None;

Purpose
Uveitis is a vision-threatening disease with varying etiologies and subtypes, which is often associated with a systemic disease. The typical features and clinical patterns may be varied among different populations depending upon geographic locations and socioeconomic variations. We aim to investigate the clinical patterns and visual outcomes of uveitis and its associations with systemic diseases in a large case series in China.

Methods
We examined the records of 15373 consecutive uveitis cases referred to our center from 31 provinces across mainland China from April 2008 to August 2018, and investigated demographic characteristics, ocular involvement and prevalence of systemic diseases. Kaplan Meier survival analysis was used to estimate the cumulative rates of uveitis-related visual impairment and blindness since the diagnosis of uveitis was made at our center.

Results
In this series, the male to female ratio was 1.12. The average age of uveitis onset was 35.4±15.9 years. Bilateral disease was observed in 61.6%. Anterior uveitis (45.3%) was the most predominant anatomical location, followed by panuveitis (35.8%), posterior uveitis (16.8%) and intermediate uveitis (2.1%). Up to 36 different systemic diseases were associated with uveitis, accounting for 34.0% of all cases. Of 12.6% cases were diagnosed as specific uveitis entities. The rest (53.4%) were diagnosed as idiopathic disease. Vogt-Koyanagi-Harada disease, Behçet’s disease (BD), ankylosing spondylitis, and juvenile idiopathic arthritis (JIA) were the most common systemic diseases. The average follow-up time was 16.4±21.3 months. A total of 2668 cases progressed to visual impairment and 880 cases developed permanent blindness. The 5-year cumulative rate of blindness was 15.2% (12.2-18.4) for the whole uveitis group and was 20.5% (15.8-25.7) for those with systemic disease. Male gender, older age, bilateral involvement, posterior uveitis or panuveitis, and certain systemic diseases (BD, JIA and syphilis) were independent risk factors for blindness.

Conclusions
Systemic diseases are commonly associated with uveitis. These patients are often at a high risk of developing irreversible visual loss. The current study provides insight into the spectrum and visual outcomes of uveitis in the largest case series, up to date, in China.

Layman Abstract (optional): Provide a 50-200 word description of your work that non-scientists can understand. Describe the big picture and the implications of your findings, not the study itself and the associated details.
Evidence suggests that a large variety of systemic diseases are causally associated with uveitis, whereby some may account for irreversible loss of vision if not diagnosed or treated promptly. The current study underscores the importance in detection and surveillance of associated systemic diseases in patients with uveitis.