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Christopher Compton, Carrie Huisingh, Gerald McGwin, Russell Read, Kinley Beck; Epidemiology of Infectious Uveitis in Alabama. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5188.
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To report the epidemiology of infectious uveitis among a referral population in the Southeast United States. In addition, to analyze the epidemiology of infectious uveitis in a United States population with a high percentage of African Americans.
We evaluated demographic and clinical data from 780 consecutive patients referred to the University of Alabama - Birmingham (UAB) Uveitis Clinic.
The average age at initial visit for the total population was 46.5 years of age, 48.9 and 46.2 for infectious and non-infectious respectively (p=0.2717). The total population (n=780) included 259 (33.2%) males and 522 (66.8%) females. Among infectious cases (n=80): 42 patients (52.5%) were males and 38 (47.5%) were females; 22 (27.5%) were African American, 55 (68.8%) were Caucasian and 3 (3.8%) identified themselves as "other". There were 325 (41.6%) African American patients, 433 (55.4%) Caucasians, and 23 (2.9%) "other". There were a total of 700 non-infectious cases. Males comprised 217 (31.0%) of non-infectious cases while there were 484 (69%) females (p=0.0001). Among non-infectious cases, 303 (43.2%) were African American patients, 378 (53.9%) were Caucasian patients, and 20 (2.9%) "other" (p=0.0259). The three most common non-infectious etiologies were: 388 idiopathic (55.3%), 79 HLA-B27 associated (11.3%), and Sarcoid 44 (6.3%). The most common infectious etiologies were: Herpes Zoster 19 (23.8%), Toxoplasma retinitis (17.5%), and Herpes Simplex (11.3%). Among the cases of Herpes Zoster related uveitis, 17 (90.9%) were Caucasian (p=0.0135). All 3 cases of HTLV related uveitis were African Americans (p=0.0211). Of cases of toxoplasma retinitis, 11 (78.6%) were males and 3 (21.4%) were females (p=0.0315).
Cases of uveitis with infectious etiologies were more likely to be posterior and non-infectious cases were more likely anterior (p=0.025). Among infectious etiologies, the most common diagnosis was Herpes zoster at 23.8%, followed by toxoplasmosis at 17.5% and Herpes simplex at 11.3%. Our study had a higher incidence of syphilis (8.8%) than previous epidemiologic studies (1-3%). Herpes zoster occurred significantly more often in Caucasians than in African Americans (p= 0.013). In African Americans, there was a relatively higher incidence of Syphilis and Lyme disease although not statistically significant. (p= 0.097 and p=0.068). Males were statistically more likely to have a diagnosis of toxoplasmosis (p=0.032).
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