Purpose:
Evidence exists that uveitis may affect various ethnic groups differently. Severe uveitis resistant to first line therapy necessitates the use of immunomodulatory therapy. Thus if ethnic groups are affected differently by uveitis, it would be expected that differences in the need for such therapy would exist. The current study compared the need for immunomodulatory therapy between ethnic groups within a tertiary uveitis referral center.
Methods:
All patients seen during 2008 on the Uveitis and Ocular Inflammatory Diseases Service at the University of Alabama at Birmingham with a diagnosis of non-infectious uveitis were identified by clinic billing records. ICD-9 diagnostic codes were used to identify the subset of patients who were on immunomodulatory therapy; a retrospective chart review collected data on this patient subset for each clinic visit. Statistical analyses were performed for differences in the proportion of races on and not on immunomodulatory therapy as well as for differences in patient specific characteristics between African-Americans and Caucasians.
Results:
406 patients were seen during 2008 with non-infectious uveitis. 107 (26%) were on immunomodulatory therapy at some point during their clinical care. Of the 406 patients, 33% of African-Americans and 26% of Caucasians required immunomodulatory therapy, p=0.067.
Conclusions:
Approximately one-quarter of all patients with non-infectious uveitis required immunomodulatory therapy. African-Americans showed a trend toward a greater need for immunomodulatory therapy.Comparing patients on immunomodulatory therapy, African-Americans were more likely to be younger, female, and with anterior or panuveitis of idiopathic cause. African-Americans appear to require earlier institution of therapy and for anatomical categories of disease that differ from Caucasians.
Keywords: uveitis-clinical/animal model • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • immunomodulation/immunoregulation