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Martha Skup, Namita Tundia, Rachael Sorg, Chen Zhao, Jingdong Chao, Parvez Mulani, Andrew D Dick; Risk of Ocular Complications in Non-infectious Uveitis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6032.
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Non-infectious uveitis (NIU) is characterized by immune-mediated intraocular inflammation that results in ocular complications. Risk of developing ocular complications in privately insured US patients with non-anterior NIU was assessed and compared with matched controls.
Patients 18-64 years old with ≥2 non-anterior NIU diagnoses (intermediate-, posterior- or pan-uveitis: ICD-9: 360.12, 362.12, 362.18, 363.0x, 363.10-363.13, 363.15, 363.2x, 364.24) from 01/01/1998 to 03/31/2012 were identified in the OptumHealth claims database. Patients were required to have continuous eligibility ≥6 months before (baseline period) the index date (date of first diagnosis). Non-anterior NIU patients (cases) were matched 1:1 by sex, age, region, company, employment status, and index date to controls without a diagnosis of uveitis. Patients with an ocular complication at baseline were excluded. Risks of developing ocular complications (glaucoma, cataract, visual disturbances, blindness/low vision, retinal detachment or disorders) during the follow-up period were compared using unadjusted Kaplan-Meier log-ranked survival analysis, estimating risk of and time to complications, and adjusted Cox regression analysis, estimating hazard ratios.
1,769 cases and 1,769 controls met the inclusion criteria (mean age, 47 years; 46.7% male). During the follow-up period, non-anterior NIU patients had a higher risk of any ocular complication (P<.001); the 5-year risk of any ocular complication was 66.4% for patients vs 23.9% for controls (figure, also showing 1- and 10-year complication risks). Specifically, non-anterior NIU patients had a higher risk (P<.001) of glaucoma (5-year: 20.2% vs 9.2%), cataract (5-year: 35.1% vs 13.1%), visual disturbance (5-year: 29.1% vs 8.7%), blindness/low vision (5-year: 4.5% vs 0.5%), retinal detachment (5-year: 10.7% vs 0.8%), and retinal disorder (5-year: 28.1% vs 1.7%). Results were supported by adjusted regression analysis (table).
Non-anterior NIU is associated with ocular complications such as glaucoma, cataract, visual disturbances, blindness/low vision, retinal detachment or disorders. Optimal treatment initiatives remain imperative to reduce ocular complication-related burden.
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