A Decade-Long Review: Insights into Diagnosis and Disease Trajectory of Uveitis from a Single-Center Study

Abstract

Abstract Purpose To analyze the evolution of uveitis diagnosis over a 10-year period, emphasizing the change in etiological diagnosis, and the factors associated with recurrences. Design: Retrospective chart review Methods A total of 15000 patients with uveitis presented to our tertiary care institute in North India between 1992 and 2023. Of these,123 patients completed 10-year follow-up and were included in the study. The data of patients was collected on an offline purpose-built uveitis registry portal:Ocular Autoimmune Systemic Inflammatory and Infectious Study(OASIS). Results The study included 123 patients (48.78% males; mean age:29.11 ± 15.22 years).The most common anatomical and etiological diagnosis at presentation were anterior (49/123,34.96%) and idiopathic(59/123,47.97%) uveitis respectively.At the end of 10 years, anterior uveitis remained the most common anatomical diagnosis(43/123,39.83%) while the most common etiological diagnosis was immune-mediated uveitis(50/123,40.65%). An etiological diagnosis could be established in 50.85%(30/59) of patients initially labelled as idiopathic.Tuberculous uveitis(39/44,88.63%) and Juvenile Idiopathic Arthritis associated uveitis (16/49,32.65%) were the commonest infectious and immune-mediated etiologies at the 10-year follow-up. Ninety-six(80.67%) patients experienced multiple episodes of ocular inflammation with a mean recurrences rate of 0.386 ± 0.24 recurrences/year. Anterior uveitis(p = 0.01), the change in etiological diagnosis after the first year(p = 0.03), positive HLA-B27 at baseline(p = 0.04), and the diagnosis of a systemic disease prior to onset of uveitis were associated with higher recurrences rates(p = 0.03). Conclusion Over 10-year of follow up, half of the uveitis diagnosis evolved from idiopathic to specific infectious or immune-mediated etiologies.Our results indicate that patients with a high recurrence rate may benefit from re-evaluation to find the definitive cause of uveitis.