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Abstract Number: 1919

Rheumatology-Ophthalmology Collaborative Uveitis Units May Improve The Diagnostic Approach Of This Pathology: Experience From a Uveitis Unit In a Secondary Spanish Hospital

Elena Aurrecoechea1, Ana Diez del Corral2, Angel de la Mora2, Jaime Calvo-Alén3 and Ernesto Romera4, 1Hospital Sierrallana. Torrelavega, Torrelavega, Spain, 2Ophthalmology, Ophthalmology Unit Hospital Sierrallana, Torrelavega, Spain, 3Rheumatology, Hospital Universitario Sierrallana, Torrelavega, Spain, 4Ophthalmology, Hospital Sierrallana Torrelavega, Torrelavega, Spain

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Uveitis

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Session Information

Session Title: Health Services Research, Quality Measures and Quality of Care - Innovations in Health Care Delivery

Session Type: Abstract Submissions (ACR)

Background/Purpose: Uveitis is defined as an intraocular inflammation, and may be associated to a systemic disease, it has a worldwide distribution, and it is a significant cause of blindness. As such the creation of Uveitis Units with the association of Rheumatologists and Ophthalmologists is highly recommended. The aim of this study is analyze the Etiology of the Uveitis diagnosed in the first three years of this unit and share our experience.

Methods: This study includes 125 patients, new and long standing, with Uveitis examined in the last three years. All patients were evaluated by the Ophthalmologist and the Rheumatologist including a detailed history and examination. A questionnaire about family and medical history were given (a Spanish translation from uveitis.org questionnaire), and guided by the evaluation  a blood test, chest ray, OCT , retinal angiography or other test were ordered as needed.

Results: The most common form of uveitis was anterior uveitis (67.2%) and the most common diagnoses were Idiopathic (44%), Ankylosing spondylitis (17.8%), Herpes (14.3%), HLA-B27 (9.5%), Fuchs Heterochromic Iridocyclitis( 3.5%).

The second most common uveitis type was posterior uveitis (16.8%) and the most common diagnoses were toxoplasmosis (42.9%), Serpiginous  choroidopathy (23.8%), idiopathic  (23.8%),  Tuberculosis (4.8%) and Vogt Koyanagi Harada disease (4.8%).

Panuveitis was diagnosed in 8.8% of the cases and the most frequent causes were idiopathic (54%), Behçet’s disease (18.8%), Endophthalmitis (9%), and Toxoplasmosis (9%).

The less frequent type of uveitis was intermediate uveitis with 7.2% of the diagnoses, most of the cases were idiopathic (66.6%), but sarcoidosis (11%), syphilis (11%), and multiple sclerosis (11%) were other etiologies found.

 There were no eyes with final visual acuity worse than 20/200 in these 3 years with non-infectious uveitis.

Anterior  Uveitis                       67.2%

Intermediate

 Uveitis                 7.2%

Posterior

Uveitis              16.8%

Panuveitis               8.8%

Idiopathic                                 44%

Idiopathic           66.6%

Toxoplasmosis  42.9%

Idiopathic               54.4%

Ankylosing Spondylitis            17.8%

Multiple                

Sclerosis             11%    

Serpiginous 

choroidopathy   23.8%

Behçet’s

 disease                   18.8%

Herpes                                     14.3%

Syphilis               11%

Idiopathic          23.8%

Endophthalmitis        9%

HLA-B27+                                 9.5%

Sarcoidosis         11%

Tuberculosis        4.8%

Toxoplasmosis          9%

Fuchs heterochromic

 Iridocyclitis                             3.5%

VKH                      4.8%

 

Psoriasis                                   2.4%

 

 

 

Sarcoidosis                               2.4%

 

 

 

AIJ                                            2.4%

 

 

 

TINU                                         1.2%

 

 

 

IBD                                           1.2%

 

 

 

Rheumatoid arthritis                1.2%

 

Conclusion: This secondary center based study shows the  type and etiology of uveitis in our population, and how a multidisciplinary approach can improve the rate of diagnosis and prognosis for patients permitting a ready access to new and better treatments in an effective way, leading to a satisfying experience for the Rheumatologist and Ophthalmologist alike.



Disclosure:

E. Aurrecoechea,
None;

A. Diez del Corral,
None;

A. de la Mora,
None;

J. Calvo-Alén,
None;

E. Romera,
None.

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