Abstract
Purpose: :
To describe the ethnic variation in uveitis presentation among Chinese, Malays and Indians in Singapore.
Methods: :
Cross sectional study using retrospective database and medical chart review of 1236 Singaporeans who consulted the Singapore National Eye Centre uveitis clinic between 1997 and 2010. Consecutive patients were registered in a uveitis database since 1997. Clinical presentations were described in terms of their ocular anatomical involvement, laterality, and known etiology. Prevalence rates were age adjusted to year 2010 population census. The likelihood of various specific etiologies were presented as adjusted odds ratios (OR) adjusting for gender, ethnicity and age groups (<21, 21-40, 41-60, >60 years).
Results: :
Among all ethnic groups, anterior uveitis (AU) was the commonest, followed by panuveitis, posterior and intermediate uveitis. Among patients with uveitis, anterior uveitis was more common among Chinese (age adjusted 63.7%) compared to Malays (47.3%, P=0.003) and Indians (37.5%, P=0.01). AU was more common among male uveitic patients (67.0% vs 52.5%, P<0.001). Panuveitis was also more common among Malays and Indians with uveitis compared to Chinese (29.5% vs 14.4%, P=0.003; 26.1% vs 14.4%, P=0.02 respectively). The commonest anterior uveitides were HLA B27 AAU, idiopathic AAU and cytomegalovirus (CMV) AU. Intermediate uveitis were mostly idiopathic and more common among younger age groups (P trend <0.001) and female patients (17.3% vs 7.0%, P<0.001). The commonest posterior uveitides were CMV retinitis, toxoplasmosis, tuberculosis (TB)-related uveitis.The commonest panuveitis uveitides were Vogt-Koyanagi Harada disease, TB and Behcet’s disease. Chinese with AU were more likely to have HLA B27 AAU than Malays (OR 3.03, 95%CI 1.58-5.79) and Indians (OR 2.34, 95%CI 1.14-4.80). They were also more likely to have CMV AU than Malays (OR 3.27, 95%CI 1.18-9.07) and Indians (OR 8.64, 95% CI 1.19-62.87). Among patients with panuveitis, Indians and Malays were more likely to have TB-related uveitis compared to Chinese (OR 7.79, 95%CI 2.36-25.8; OR 7.79, 95%CI 2.74-22.14 respectively).
Conclusions: :
There are differences in the commonest uveitides encountered among different ethnic groups living in Singapore.
Keywords: autoimmune disease • clinical (human) or epidemiologic studies: prevalence/incidence • cytomegalovirus