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Meghan Berkenstock, Eileen Chang, Jessica M Ackert; Uveitis Demographics in an Indigent Population. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3122.
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Patients with uveitis require treatment with topical and oral medications to adequately resolve inflammation. The side-effects of these medications require frequent lab studies and long-term follow-up. For patients with no insurance or minimal coverage, suboptimal compliance may result. There have been no studies examining the types of uveitis and visual outcomes at large hospitals serving indigent populations in need of low-cost care. By understanding the types of uveitis and populations we are serving, the study allows us to focus on obtaining resources for these patients.
A database of uveitis-related ICD9 codes from 9/2011 through 9/2014 at Drexel Eye Physicians was created. Charts of 647 patients were retrospectively reviewed. Primary endpoints were determining the anatomic location of the uveitis and demographic factors, such as race and gender.
Results: Based on diagnosis codes, 647 charts were reviewed and 249 patients were included. Patients were excluded if there was no documentation of endogenous anterior, intermediate, posterior, or panuveitis. Anatomic location and activity was graded according to SUN. The most common anatomic location was anterior (76.3%), followed by panuveitis (14.9%), posterior (6.8%), and intermediate (2%). In affected patients, the most commonly represented ethnic groups were African-American (65.5%), Caucasian (16.9%), and Hispanic (10%). Patients with anterior uveitis did well with the majority achieving 20/20 vision. Patients with pan or posterior uveitis had a higher rate of vision loss. The most common disease entities were post-op inflammation (13.65%), sarcoid (6.4%), toxoplasmosis and HZO (2% each). In cases of anterior uveitis, 144 cases were acute (75.79%) and 46 chronic (24,21%). Unilateral was more common than bilateral, 62.25% versus 37.75%. There were more females, 65.5%, than males, 34.5%. The prevalence rate was based on a total of 23,290 office visits, which totaled 0.77% of patients.
The diverse population seen in Philadelphia allows for a wide variety of conditions presenting at our uveitis specialty clinic. The study has allowed us to identify the entities that are encountered in our primarily indigent population and assist them in affording long term treatment. The majority of patients are African-American with anterior uveitis who had good visual outcome. Further evaluation is needed to determine what barriers to care can be removed to improve outcome.
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