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Rina Okazawa, Kei Takayama, Tomohito Sato, Kozo Harimoto, Takayuki Kanda, Masaru Takeuchi; Identification of distinct characteristics underlying in various anterior uveitis. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3930 – A0473.
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© ARVO (1962-2015); The Authors (2016-present)
Anterior uveitis (AU) is the most common form of uveitis and an important condition encountered both in primary care unit and specialist uveitis clinics. There are several known and many possible etiologies for AU, and clinical characteristics in AU differ depending on the cause. In this study, we focused on AU and investigated the detailed epidemiological profile and the clinical finding-related differences.
Clinical charts of consecutive 275 patients with 335 eyes (mean age 52.5 ±19.1 years, male/female = 124/151) who made a first visit at National Defense Medical College Hospital between January 2010 and March 2020 were retrospectively reviewed. Visual acuity, intraocular pressure (IOP), unilateral/bilateral uveitis at first visit, and diagnosis, were collected from clinical charts. In eyes suspected infectious uveitis, multiplex polymerase chain reaction tests (PCR) using anterior aqueous humor were performed as previous reports, and diagnosed.
Epidemiologically, acute AU was the most frequent (21.8%), followed by viral AU (20.7%) consisting of varicella zoster virus (VZV) at 9.1%, herpes simplex virus (HSV) at 8.0%, and cytomegalovirus (CMV) at 3.6%, scleritis (13.5%), diabetic iritis (7.6%), and Posner-Schlossman (P-S) syndrome (5.5%), although unexplained cases were 17.1%. Unilateral AU was 78.2% of the total, of which 86.7% of acute AU, 96.5% of viral AU (VZV 100%, HSV 100%, and CMV 80%), 75.7% of scleritis, 57.1% of diabetic iritis, and 100% of P-S syndrome. One hundred eleven AU patients (40.4%) were more than 60 years old, which were composed of viral AU at 34.2% (VZV 14.4%, HSV 12.6%, and CMV 7.2%), scleritis at 14.4%, acute AU at 13.3%, P-S syndrome at 6.3%, and diabetic iritis at 4.5%. AU patients with visual disturbance less than 20/30 accounted for 36% of the total, which consisted of 46.7% of acute AU, 50.9% of viral AU (VZV 48%, HSV 54.5%, and CMV 50%), 16.2% of scleritis, 47.6% of diabetic iritis, and 55.6% of Fuchs’ uveitis. Comparing acute AU and viral AU, viral AU patients were significantly older and had higher intraocular pressure than acute AU patients.
AU is predominantly unilateral, and the etiology was identified in about 80%. The most frequent disease was acute AU, followed by viral AU, and visual acuity was equally impaired in them. However, it was suggested that viral AU patients were older and had higher IOP than acute AU patients.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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