ObjectiveTo estimate the incidence and describe the demographic characteristics of keratoconus (KC) in Colombia using national health registry data between January 1st 2015 and December 31th 2020.Methods and analysisWe conducted a nationwide, population-based study using the Integrated Social Protection Information System from the Colombian Ministry of Health, the unique official database in the country. We used the International Classification of Diseases code for KC (H186) to identify the number of new cases of KC and estimate the incidence rates both overall and according to age and sex. We made a standard morbidity ratio map to graph Colombia’s morbidity risk of KC onset.ResultsOf 50 372 424 subjects, 21 710 had KC between 2015 and 2020. However, due to the COVID-19 pandemic, all the incidence rates of this study were based on the 18 419 reported until 2019. The incidence rate in the general population was 10.36 (95% CI 10.08 to 10.64) per 100 000 inhabitants. The incidence peak among males was in their early 20s and females in their late 20s. The overall male to female incidence rate ratio was 1.60. Regarding the distribution of the disease, most cases were reported in Bogotá (48.64%), Antioquia (14.04%) and Cundinamarca (10.38%).ConclusionWe performed the first nationwide, population-based study of KC in Latin America, finding distribution patterns similar to those reported in the literature. This study provides valuable information on the epidemiology of KC in Colombia, which is helpful in the development of policies for the diagnosis, prevention and treatment of the disease.
<b>Hintergrund:</b> Ziel dieser Studie war, über einen Fall von bilateraler anteriorer, nichtgranulomatöser, chronischer, nichtinfektiöser Uveitis assoziiert mit isolierter Nagelpsoriasis ohne Gelenkbeteiligung zu berichten. <b>Falldarstellung:</b> Ein 55-jähriger Mann mit Offenwinkelglaukom in der Anamnese wurde an unser Uveitis- und Augenimmunologiezentrum mit einer intraokularen Entzündung übereinstimmend mit chronischer, nichtinfektiöser, bilateraler nichtgranulomatöser Uveitis überwiesen. Bei Vorstellung hatte er bilateral eine moderate Entzündung in der Vorderkammer sowie für Nagelpsoriasis charakteristische Läsionen. Die Nagelpsoriasis wurde später durch den Nagel-Ultraschall bestätigt, der von einem auf Psoriasis spezialisierten Radiologen durchgeführt wurde. Es wurden geeignete klinische und paraklinische Untersuchungen durchgeführt, die alle anderen möglichen Ursachen der Uveitis ausschlossen. Der Patient benötigte eine duale systemische immunmodulatorische Therapie mit Methotrexat und Adalimumab, topische entzündungshemmende Medikamente (steroidale und nichtsteroidale) und eine Anti-Glaukom-Therapie, um eine zufriedenstellende Kontrolle von Entzündung und Augendruck zu erreichen. <b>Diskussion und Schlussfolgerungen:</b> Dies ist der erste Bericht über eine nichtinfektiöse Uveitis im Zusammenhang mit einer Nagelschädigung bei einem Patienten ohne andere Manifestationen von Psoriasis. Trotz Berichten über den Zusammenhang zwischen Psoriasis und Uveitis liegen unzureichende Informationen über klinische Phänotypen in Kombination mit Uveitis vor, die zu einer späteren Diagnose und Behandlung der assoziierten intraokularen Entzündung führen könnten. Kliniker sollten sich aller Subtypen von Psoriasis bewusst sein, die bei diesen Patienten das Risiko für die Entwicklung einer Uveitis erhöhen.
Background This study aimed to report a case of bilateral anterior non-granulomatous chronic non-infectious uveitis associated with isolated nail psoriasis without articular involvement. Case presentation A 55-year-old man with a history of open-angle glaucoma was referred to our uveitis and ocular immunology center with intraocular inflammation concordant with chronic non-infectious bilateral anterior non-granulomatous uveitis. At presentation, he had moderate inflammation in the anterior chamber bilaterally and lesions characteristic of nail psoriasis. Nail psoriasis was later confirmed by nail ultrasonography performed by a radiologist who specialized in psoriasis. Appropriate clinical and paraclinical assessments were conducted, ruling out all other possible causes of uveitis. The patient required dual systemic immunomodulatory therapy with methotrexate and adalimumab, topical anti-inflammatory drugs (steroidal and non-steroidal), and anti-glaucoma therapy to achieve satisfactory inflammatory and ocular pressure control. Discussion and conclusions This is the first report of non-infectious uveitis associated with nail compromise in a patient without other manifestations of psoriasis. Despite reports on the relationship between psoriatic disease and uveitis, there is insufficient information on clinical phenotypes associated with uveitis that could lead to later diagnosis and treatment of associated intraocular inflammation. Clinicians should be aware of all subtypes of psoriasis that increases a risk of developing uveitis in these patients.
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