Uveitis: Epidemiological trends in risk and association with systemic diseases
Purpose
To estimate 22-year trend in uveitis prevalence, incidence, and association with I-IMIDs.
Methods
Cross-sectional and population cohort analysis of a nationally-representative primary care database; matched case-control and matched cohort (n=24,895 incident uveitis patients matched 1:4 controls)
Results
Incident uveitis patients were 53.6% female, median age 46.7(IQR 33.6-61.4)years, and 86.7% White. Incidence declined from 43.1(95% CI 36.4-49.7) to 28.2(26.2-30.1)/100,000 person-years from 1997-2018. 2018 annual point prevalence was 658.7(649.6-667.8)/100,000, affecting 433,768(427,765-439,771). Multivariable Poisson regression analysis identified higher risk of incident uveitis with female sex, obesity, older age, and Black, South Asian and other race/ethnicity compared to White. Uveitis significantly associated with dozens of I-IMIDs, with >10-fold increased likelihood of prior(odds ratio) or subsequent(hazard ratio) diagnosis of ankylosing spondylitis(aOR20.3[16.7-24.8], aHR43.8[31.4-61.2]; JIA(aOR15.3[8.9-26.3]; relapsing polychondritis(aOR14.0[2.9-68.8], aHR32.5[4.0-263.1]), tubulointerstitial nephritis(aOR12.4[5.2-29.4], aHR10.6[5.1-22.2]); reactive arthritis(aOR11.8[7.7-18.0], aHR37.2[8.5-161.8]); behçet's disease (aHR26.4[11.1-62.5]); sarcoidosis(aHR16.3[12.8-20.8]); GPA(aHR12.8 [5.5-29.8]); and infection with toxoplasma(aOR12.6[8.3-19.0], aHR133.8[42.3-422.8]); cytomegalovirus(aHR26.2[3.2-215.7]); and syphilis(aHR17.0[7.0-41.2])
Conclusion
UK uveitis incidence is declining. Interplay between ophthalmologically managed uveitis and I-IMIDs highlights need for multi-specialty care
Conflict of interest
No
Authors 1
Last name
BRAITHWAITE
Initials of first name(s)
T
Department
The Medical Eye Unit, Guy's and St Thomas' NHS Foundation Trust
City
London
Country
United Kingdom
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