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Nathan Eli Hall, Tobias Elze, Lucia Sobrin, Joan W Miller, Alice Lorch; Characteristics of patients with Sympathetic Ophthalmia in the American Academy of Ophthalmology’s IRIS® Registry. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2054.
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© ARVO (1962-2015); The Authors (2016-present)
Sympathetic ophthalmia (SO) is a bilateral, granulomatous uveitis resulting from an autoimmune reaction to ocular antigens exposed in trauma or surgery. We used the IRIS Registry to characterize the presentation of SO across cohorts post procedure and post trauma.
A cohort of N=4,135 patients with at least one diagnosis of SO was identified by ICD code in the IRIS Registry. From this cohort, patients with an intraocular procedure in or before the year of SO diagnosis were identified by CPT code (N=751) and patients with a trauma-related diagnosis in or before the year of SO diagnosis were identified by ICD code (N=271). 66 patients had both a trauma-related diagnosis and procedure and so were removed from both cohorts. For the procedure cohort, only the earliest-recorded procedure was included in the data for each patient such that there was only one observation per patient in the final data set. Descriptive statistics, a Pearson's chi-squared test, and a two-sample t-test were conducted for key demographic factors within the procedure-only cohort (POC), trauma-only cohort (TOC), procedure with trauma cohort (PTC), and across all three cohorts combined (N=1,087).
In the entire cohort of SO patients (N=4,135), 57.6% of patients were female. In the POC (n=750), the average age at onset of SO was 66.62 (SD=12.38) with mean years to onset after procedure 1.67 (SD=2.97) and 66.79% of patients were female. In 78.92% of patients, the preceding procedure was cataract extraction with IOL implantation. In the TOC (n=271), the average age of onset of SO was 56.92 (SD=19.04) and 52.52% of patients were female. In the combined cohort (N=1087), the average age at onset of SO was 63.69 (SD= 15.32) with mean years to onset after most recent procedure or trauma 1.67 (SD=2.97) and 62.74% of patients were female. The ratio of female to male was significantly higher in the POC compared to the TOC (p< 0.001). There was no significant difference in mean years to SO onset from procedure between males and females in the POC (p=0.15).
Our results characterize SO presentation across the IRIS Registry and suggest a significantly higher risk of SO in females compared to males post-procedure compared to post-trauma, which has not been previously demonstrated. This gender difference can be seen in other autoimmune processes and warrants further investigation.
This is a 2020 ARVO Annual Meeting abstract.
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