Background/Purpose: Defined as an intraocular inflammation, uveitis may be associated to a systemic disease or represent an isolated entity. It affects people from all parts of the world, and it is a significant cause of severe visual impairment, accounting for 10% of blindness in the Western world. Screening for associated extra-ocular manifestations is mandatory in uveitis patients. The aim of the study was to analyse the etiology and the pattern of uveitis in a cohort of patients followed in the context of a uveitis clinic of a rheumatologic referral centre

Methods: The study included 120 patients (M/F: 86/34; mean age at disease onset 35 years) with uveitis examined from January 2009 to May 2012. All patients had a comprehensive rheumatologic and ophtalmological evaluation, including: clinical history,  Snellen visual acuity, slit-lamp examination, applanation tonometry, dilated fundus examination and/or visual field and/or fluorescein-angiography and/or optical coherence tomography. Moreover, all patients underwent the standard protocol of serological examinations for uveitis, including routine examination, acute phase reactants, HLA typing, serum fluorescent treponemal antibody absorption detection, main viral and bacterial screening, serum angiotensin-converting enzyme, serum lysozyme, tuberculin reaction tests, non-organ specific auto antibodies profile and, when required, chest X-Ray.

Results: Seventy percent of patients referred by ophthalmologists, 27% patients directly attending our department and 3% referred by general practitioners. Posterior uveitis was the most common feature (46%), followed by anterior uveitis (28%), panuveitis (16%), and intermediate uveitis (10%). For 57 of 120 (47%) patients with uveitis, a specific aetiologic diagnosis was established, while 53% of patients  were found to have idiopathic uveitis. In the posterior uveitis group (n=55), a specific diagnosis was made for 21 patients (38%); the most frequent forms were represented by toxoplasmosis (48%) and Behçet’s disease (25%). In the anterior uveitis group (n=34), a specific diagnosis was made in 19  patients (56%). The most common diagnoses included herpetic infection (53%), Fuchs’ heterochromic iridocyclitis (22%), HLA-B27-positive anterior uveitis ± associated to a spondylarthropathy (20%). Among patients with panuveitis (n=19), 15 (79%) had a specific aetiologic diagnosis, in the majority of cases linked to Behçet’s disease (88%). In the intermediate uveitis group (n=12) only two etiologies were identified: sarcoidosis and multiple sclerosis.

Conclusion: In this hospital-based study, the most common cause of uveitis is idiopathic. However, a multi-disciplinary approach may surely improve the diagnosis of uveitis secondary to autoimmune diseases.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/etiology-of-uveitis-a-hospital-based-study-in-a-referral-centre/