Purchase this article with an account.
T. K. Yeo, W. K. Lim, S. C. B. Teoh, S. L. Ho; Causes of Visual Loss Associated With Uveitis in a Singapore Tertiary Eye Centre. Invest. Ophthalmol. Vis. Sci. 2009;50(13):292.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To investigate the spectrum of uveitis in a Singapore tertiary eye centre by evaluating demographic and clinical data to identify causes of visual loss and potential risk factors.
A retrospective, cross-sectional, non-interventional review of 381 consecutive patients attending a tertiary uveitis service in Singapore. Visual loss was defined as 6/12 or worse, and severe visual loss as 6/60 or worse.
The ethnic distribution was comparable with Singapore’s general population. There were 218 (57.2%) male and 163 (42.8%) female patients. Mean age of presentation was 43.9 years. The most common presentation was anterior uveitis (n = 245, 64.3%) followed by panuveitis (n = 58, 15.2%). Infective cases made up 22.3% and 147 (38.6%) patients had bilateral involvement. Visual loss occurred in 108 (28.3%) patients and 31 (8.1%) patients had severe visual loss. The main causes of visual loss were cataract (22.2%), macular pathology (eg. macular scarring excluding cystoid macular edema) (15.7%), glaucoma (11.1%) and cystoid macular edema (9.2%). Posterior uveitis and panuveitis both showed higher risk of visual loss (p = 0.017, odds ratio 2.731 and p = 0.010, odds ratio 2.542 respectively) and severe visual loss (p = 0.001, odds ratio 8.553 and p < 0.001, odds ratio 7.456 respectively) compared to anterior uveitis. Chronic uveitis also showed a higher risk of severe visual loss compared to acute uveitis (p = 0.014, odds ratio 4.195). Furthermore, age of presentation was associated with a 3.5% increased risk of visual loss per year (p < 0.001). There was no statistical difference in visual loss between infective and non-infective uveitis.
Cataract, macular pathology, glaucoma and cystoid macular edema were the main causes of visual loss. Posterior uveitis, panuveitis and chronic disease all predisposed to poor visual outcome. More aggressive management may be indicated for such at-risk patients to prevent visual loss. In addition, with panuveitis being the second most common presentation in the local population and later presentation predisposing to worse visual prognosis, there is a need for heightened uveitis awareness and early referral to specialist care.
This PDF is available to Subscribers Only