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Helen Mi, Su Ling Ho, Wee Kiak Lim, Elizabeth Poh Ying Wong, Stephen C B Teoh; Trends in Patterns of Posterior Uveitis and Panuveitis in a Tertiary Institution in Singapore. Invest. Ophthalmol. Vis. Sci. 2014;55(13):106.
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The study aims to analyze the pattern of etiology trends and clinical characteristics of posterior uveitis and panuveitis patients seen by a tertiary eye center in Singapore over 9 years.
We conducted a retrospective analysis of 365 consecutive cases of posterior uveitis and panuveitis, out of a total of 1355 uveitis patients, between 2004-2012. Data collected included demographics, clinical and laboratory findings. Diagnoses for specific ocular entities or systemic disease associations were based on standardized clinical history, systemic review, complete ophthalmological examination and investigations. The cases were segregated into idiopathic, infectious or non-infectious categories.
Majority of the cases were infectious (n=160, 43.8%), followed by non-infectious (n=152, 41.6%) and idiopathic (n=53, 14.5%). We found statistically significant differences between etiology categories and laterality (p=0.041), age (p=0.033), and ethnicity (p=0.018). We noticed a statistically significant (p=0.010) downward trend for the infectious etiology category (Spearman’s rho (ρ) = -0.795) over the period of study. There was a similar downward trend (Spearman’s rho (ρ) = -0.812, p=0.008) for the most common infectious etiology, dengue uveitis (n=61, 38.1%). We found a significant (p=0.019) upward trend for the idiopathic category (Spearman’s rho (ρ) = 0.753).
Comparisons with other countries revealed disparities in etiologies such as ocular toxoplasmosis, indicating possible genetic, geographical and socioeconomic differences. We also observed differences between etiology categories and ethnicity, pointing towards potential genetic susceptibility variations. Despite the introduction of new investigational tools, there was an upward trend of idiopathic causes. This could be due to better control of systemic and infectious etiologies, leading to decreased accompanying ocular complications. The dengue uveitis incidence in our study correlates well with the national statistics of dengue infections, with the highest occurrence in 2004-2005, followed by 2007. These peaks could have been caused by shifts in the predominant serotypes of the dengue virus to DENV-1 in 2004-2005, and then to DENV-2 in 2007. The downward trend of dengue uveitis noted in our study could be due to the introduction of Singapore’s dengue surveillance in 2005, emphasizing the importance of controlling the disease.
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