Referral patterns of uveitis in a tertiary eye care center
A. Rodriguez, M. Calonge, M. Pedroza-Seres, Y. A. Akova, E. M. Messmer, D. J. D'Amico and C. S. Foster
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA.
OBJECTIVE: To analyze the referral patterns and diagnosis of uveitis during
the past decade in a large tertiary eye center. DESIGN: The records of 1237
patients with uveitis referred to the Immunology Service of the
Massachusetts Eye and Ear Infirmary from 1982 to 1992 were classified and
analyzed. Data regarding sex, race, nationality, referral site, ages at
presentation and onset of uveitis, ocular involvement, clinical
characteristics, ocular condition, and systemic disease associations were
obtained. RESULTS: The mean age at onset of uveitis was 37.2 years; the
male-to-female ratio was 1:1.4. Most patients were white (85.8%), born in
the United States (83.1%), and referred from within New England (84.7%).
Anterior uveitis was most common (51.6%), followed by posterior uveitis
(19.4%), panuveitis (16.0%), and intermediate uveitis (13.0%). Chronic
(58.3%), nongranulomatous (77.7%), and noninfectious (83.1%) were the most
frequent types of uveitis. The most common entities included idiopathic
(34.9%), seronegative spondyloarthropathies (10.4%), sarcoidosis (9.6%),
juvenile rheumatoid arthritis (5.6%), systemic lupus erythematosus (4.8%),
Behcet's disease (2.5%), and the acquired immunodeficiency syndrome (2.4%).
CONCLUSION: The appearance of new uveitic entities, such as the acute
retinal necrosis syndrome, multifocal choroiditis and panuveitis, birdshot
retinochoroidopathy, and acquired immunodeficiency syndrome-related
uveitis, and the reemergence of the classic infectious causes of uveitis,
tuberculosis and syphilis, have changed the way we approach the diagnosis
and management of posterior and panuveitis at the Massachusetts Eye and Ear
Infirmary.
