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M.S. Leuchtenberger, M. Fleckenstein, T. Heger, M. Becker; Epidemiology of Secondary Uveitis in Germany . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5117.
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Purpose: The diagnosis of uveitis may conceal underlying systemic disease, infection or an ocular syndrome. Worldwide, studies on the epidemiology of such secondary forms of uveitis are rare and often small. No extensive analysis of German patients exists so far. This study aimed to analyse the frequencies of secondary forms of uveitis based on patients’ visits to the uveitis office hours of a tertiary health care center. Methods: This retrospective study included 1022 patients (median age 39 yrs.; range 1 – 89yrs.) with verified uveitis who presented at the Interdisciplinary Uveitis Center of the University of Heidelberg between October 2001 and August 2004. All patients were entered systematically into an electronic database, which served as a digital patient’s record. Analysis was performed for the following main parameters: underlying systemic disease, ocular syndrome, infection, anatomical localisation, and age group. Results: In 58% of patients, secondary uveitis was observed. Secondary uveitis was found in the following proportions: underlying systemic disease was found in 48% of secondary uveitis patients, the most frequent ones being sarcoidosis (17%) and ankylosing spondylitis (16%). Ocular syndromes were found in 34%, the most frequent ones being Fuchs’ uveitis syndrome (38%) and HLA–B27–positive anterior uveitis (27%). Infection was found in 18% of patients, the most frequent types being herpetic infections (37%) and toxoplasmosis (34%). In 42% of patients an anterior uveitis was found (mostly Fuchs' Uveitis Syndrome with 14% and HLA–B27 positive anterior uveitis with 12%), in 17% an intermediate uveitis (mostly multiple sclerosis with 9%), and in 17% a posterior uveitis (mostly toxoplasmosis with 17%). Panuveitis was found in 10% of cases, with sarcoidosis and Behcet's disease being most frequent (15% and 12% respectively). The remaining 14% of cases were distributed among extrauveal manifestations such as scleritis, episcleritis, neuritis, myositis and orbital inflammation. The very young and the very old were less often affected than the middle aged population. Among the young, juvenile rheumathoid arthritis was most frequent (23%). Between the ages 17 to 29, Fuchs' uveitis syndrome was most frequent (12%). Among the middle aged, a variety of syndromes were found equally frequently and among the elderly, the herpetic infections were found most often (7%). Conclusions: Knowledge of the epidemiology of secondary uveitis is important for rational diagnostics. The high frequency of secondary uveitis shows that an interdisciplinary approach to uveitis is of great importance.
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