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B. Bodaghi, A. Sanchez-Poton, French Severe Uveitis Study Group; Epidemiology of Severe Uveitis in France: A Prospective Multicentre Study. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3895.
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To determine the distribution and characteristics of severe uveitis, referred to university referral centres (URC) in France during a 3-month period.
All new cases of uveitis referred between January and April 2006, to 31 specialized URC, for diagnostic or therapeutic management were prospectively reviewed. Characteristics of ocular inflammation were reported at the end of the first examination on a questionnaire and collected for further analysis.
During this three-month period, 527 patients were finally included. Median age was 44.1 (range 1-95) and the sex-ratio was 1. The majority of patients (60.92%) were referred by their ophthalmologist and no previous episode of uveitis was noted in 62.75% of cases. Acute-onset uveitis was present in 68.22% of cases. Anterior uveitis was the most common type of presentation (54.7%) followed by panuveitis (21.1%), posterior uveitis (18.1%) and intermediate uveitis (6.1%). Complications at referral included a visual loss < 20/100 (20%), posterior synechiae (21.6%), secondary glaucoma (15.3%), cataract (7%), macular edema (7.8%) and retinal necrosis (1.7%). An infectious entity was suspected in 27.8% of cases. Among these patients, a viral infection was suspected in 11.6% of cases followed by toxoplasmic retinochoroiditis in 10.2% of cases. A noninfectious etiology was proposed in 46% of cases, including B27-like uveitis in 15.5% of cases and sarcoidosis in 10.5% of cases.
Even though classical forms of acute anterior uveitis are still referred to tertiary eye care centres, severe presentations of posterior or panuveitis should be managed properly. Initial ophthalmological examination is a key step for the diagnostic and therapeutic management of these patients. An infectious etiology may be easily suspected and should be excluded before the further use of corticosteroids or immunosuppressive drugs.
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