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A. D. Birnbaum, D. A. Goldstein, H. H. Tessler; Etiology of Chronic Iridocyclitis Over a 35 Year Period. Invest. Ophthalmol. Vis. Sci. 2009;50(13):290.
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Chronic iridocyclitis (CIC) is defined as anterior uveitis of greater than 12 weeks duration with no period of quiescence off treatment. Over the past several decades our knowledge of CIC has increased, including the use of newer diagnostic tests and newly described etiologies of CIC, such as Lyme disease and tubulo-interstitial nephritis and uveitis syndrome (TINU). The purpose of this study is to describe our experience with CIC over the past 35 years and determine whether we have become better at identifying the etiology of this chronic inflammation.
Medical records of patients evaluated from 1973-2007 were reviewed to identify patients with a diagnosis of CIC. Those patients with fundus lesions other than retinal periphlebitis, cystoid macular edema and disc edema were excluded. The percentage of all uveitis referrals diagnosed with CIC per 5-year period was calculated. The percentage of CIC patients with each of 18 diagnoses was also determined. A final category included uncommon causes of CIC seen infrequently over 35 years.
A total of 5788 patients were evaluated by the uveitis service from 1973-2007. Of these, 1856 fit our criteria of CIC, which represented 28.8- 37.1% of all referrals in each 5-year time period. The etiology of the CIC was idiopathic in the majority of cases throughout the study (50.4-56.8%). The next most common diagnoses were sarcoidosis (presumed and biopsy-proven), comprising 7.8-20.8% of cases per 5-year period, and Fuchs’ heterochromic iridocyclitis (6.5-16.5%).
CIC has consistently represented a significant proportion of total uveitis referrals at our institution over the past 35 years. During this time, new diagnostic tests have been developed, and new diseases identified. Despite this, the proportion of CIC that remains idiopathic has changed little over 35 years.
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