Clinical patterns and visual outcomes of uveitis and its associated systemic diseases: a 10-year case series in China

Abstract

Purpose : Uveitis is a vision-threatening disease with varying etiologies and subtypes, which is often associated with a systemic disease. The typical features and clinical patterns may be varied among different populations depending upon geographic locations and socioeconomic variations. We aim to investigate the clinical patterns and visual outcomes of uveitis and its associations with systemic diseases in a large case series in China.

Methods : We examined the records of 15373 consecutive uveitis cases referred to our center from 31 provinces across mainland China from April 2008 to August 2018, and investigated demographic characteristics, ocular involvement and prevalence of systemic diseases. Kaplan Meier survival analysis was used to estimate the cumulative rates of uveitis-related visual impairment and blindness since the diagnosis of uveitis was made at our center.

Results : In this series, the male to female ratio was 1.12. The average age of uveitis onset was 35.4±15.9 years. Bilateral disease was observed in 61.6%. Anterior uveitis (45.3%) was the most predominant anatomical location, followed by panuveitis (35.8%), posterior uveitis (16.8%) and intermediate uveitis (2.1%). Up to 36 different systemic diseases were associated with uveitis, accounting for 34.0% of all cases. Of 12.6% cases were diagnosed as specific uveitis entities. The rest (53.4%) were diagnosed as idiopathic disease. Vogt-Koyanagi-Harada disease, Behçet’s disease (BD), ankylosing spondylitis, and juvenile idiopathic arthritis (JIA) were the most common systemic diseases. The average follow-up time was 16.4±21.3 months. A total of 2668 cases progressed to visual impairment and 880 cases developed permanent blindness. The 5-year cumulative rate of blindness was 15.2% (12.2-18.4) for the whole uveitis group and was 20.5% (15.8-25.7) for those with systemic disease. Male gender, older age, bilateral involvement, posterior uveitis or panuveitis, and certain systemic diseases (BD, JIA and syphilis) were independent risk factors for blindness.

Conclusions : Systemic diseases are commonly associated with uveitis. These patients are often at a high risk of developing irreversible visual loss. The current study provides insight into the spectrum and visual outcomes of uveitis in the largest case series, up to date, in China.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Trends in visual impairment among uveitis patients

 

Trends in blindness among uveitis patients