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Leonid Zukin, Youning Zhang, Sarina Amin, Khristina I Lung, Seth Seabury, Narsing A Rao, Brian C Toy; Ocular Sequelae of Uveitis and Their Associated Risk Factors: A National Medical Claims Database Study. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1436.
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Uveitis and scleritis can cause a number of vision threatening complications if left untreated. Because the precise complications of each sub-type of uveitis can be relatively uncommon, it can be difficult to uncover clinically significant associations and risk factors for developing these complications. Here we employ a large national insurance claims database to conduct a retrospective case-control study of the long-term ocular sequelae of uveitis and scleritis.
The Optum Clinformatics Data Mart, a large national database, was used to obtain medical claims and demographic data. Patients with a diagnosis of uveitis/scleritis based on ophthalmologist or optometrist examination were included in the study. Medical claims data after 2007 was used and diagnosis codes were based on the International Classification of Diseases (ICD) 9th and 10th Revisions. Data was categorized on the basis of anatomic location/classification of uveitis – scleritis, anterior, intermediate, posterior, panuveitis. Multivariable logistic regression analysis was implemented to calculate odds ratios within each sequelae type on the basis of age, gender, ethnicity, socioeconomic status, education, smoking status, as well as numerous systemic medical comorbidities.
Of the 115,876 patients with uveitis and scleritis identified in this study, 29.4% had scleritis, 51.7% had anterior uveitis, 0.6% had intermediate uveitis, 16.1% had posterior uveitis, and 2.3% had panuveitis. The most common sequelae were cataracts (18.8%), cystoid macular edema (2.9%), blindness (1.5%), chorioretinal scarring (1.5%), and choroidal neovascularization (1.0%). Multivariate analysis revealed that cataracts were more likely in panuveitis, cystoid macular edema was more likely in intermediate uveitis, blindness was more likely in panuveitis, and chorioretinal neovascularization and scarring were most likely in posterior uveitis. Multivariate analysis further demonstrated associations of each sequelae with various demographic parameters and medical co-morbidities.
This study demonstrates the utility of employing a large database and clinical informatics to study relatively uncommon ocular diseases and to elucidate key associations and risk factors for their vision threatening complications.
This is a 2021 ARVO Annual Meeting abstract.
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