Incidence, prevalence, and risk factors of infectious uveitis and scleritis in the United States: A claims-based analysis

Zhang, Youning; Amin, Sarina; Lung, Khristina; Seabury, Seth A.; Rao, Narsing A.; Toy, Brian C.

doi:10.1371/journal.pone.0237995

Cited by 47 publications

(38 citation statements)

References 17 publications

(23 reference statements)

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“…We were unable to review medical records to validate the assigned Read codes. However, the close accordance between the scleritis incidence rate we observed and the rates observed in other large databases and epidemiologic surveys in the US was reassuring (5)(6)(7)(8)(9).…”

Section: Discussionsupporting

confidence: 86%

“…Common to previous scleritis epidemiology studies in the US (5–8), we observed higher risk of incident scleritis among women. Factors contributing to well‐established sex differences in immune‐mediated diseases are complex and multiple, with genetic, hormonal, and environmental contributions (21,22).…”

Section: Discussionsupporting

confidence: 78%

“…Knowledge of the epidemiology of scleritis is currently informed by few studies. Three US database studies showed scleritis incidence rates of 3.4 per 100,000 person-years (Northern California Epidemiology of Uveitis Study [1998][1999], 731,895 patients in a Health Maintenance Organization) (5), 4.1 per 100,000 personyears (Pacific Ocular Inflammation Study [2006][2007], 217,061 Kaiser Permanente enrollees) (6,7), and 1.6 per 100,000 personyears (infectious scleritis only) (Optum private insurance database [2007][2008][2009][2010][2011][2012][2013][2014][2015], 21.5 million insured patients) (8). Similarly, the Rochester Epidemiology Project (2006-2015, 144,248 population) showed an incidence rate of 5.5 per 100,000 person-years (9).…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of Scleritis in the United Kingdom From 1997 to 2018: Population‐Based Analysis of 11 Million Patients and Association Between Scleritis and Infectious and Immune‐Mediated Inflammatory Disease

Braithwaite

Adderley

Subramanian

et al. 2021

Arthritis & Rheumatology

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Objective To estimate 22‐year trends in the prevalence and incidence of scleritis, and the associations of scleritis with infectious and immune‐mediated inflammatory diseases (I‐IMIDs) in the UK. Methods The retrospective cross‐sectional and population cohort study (1997–2018) included 10,939,823 patients (2,946 incident scleritis cases) in The Health Improvement Network, a nationally representative primary care records database. The case–control and matched cohort study (1995–2019) included 3,005 incident scleritis cases and 12,020 control patients matched by age, sex, region, and Townsend deprivation index. Data were analyzed using multivariable Poisson regression, multivariable logistic regression, and Cox proportional hazards multivariable models adjusted for age, sex, Townsend deprivation index, race/ethnicity, smoking status, nation within the UK, and body mass index. Incidence rate ratios (IRRs) and 95% confidence intervals (95% CIs) were calculated. Results Scleritis incidence rates per 100,000 person‐years declined from 4.23 (95% CI 2.16–6.31) to 2.79 (95% CI 2.19–3.39) between 1997 and 2018. The prevalence of scleritis per 100,000 person‐years was 93.62 (95% CI 90.17–97.07) in 2018 (61,650 UK patients). Among 2,946 patients with incident scleritis, 1,831 (62.2%) were female, the mean ± SD age was 44.9 ± 17.6 years (range 1–93), and 1,257 (88.8%) were White. Higher risk of incident scleritis was associated with female sex (adjusted IRR 1.53 [95% CI 1.43–1.66], P < 0.001), Black race/ethnicity (adjusted IRR 1.52 [95% CI 1.14–2.01], P = 0.004 compared to White race/ethnicity), or South Asian race/ethnicity (adjusted IRR 1.50 [95% CI 1.19–1.90], P < 0.001 compared to White race/ethnicity), and older age (peak adjusted IRR 4.95 [95% CI 3.99–6.14], P < 0.001 for patients ages 51–60 years versus those ages ≤10 years). Compared to controls, scleritis patients had a 2‐fold increased risk of a prior I‐IMID diagnosis (17 I‐IMIDs, P < 0.001) and significantly increased risk of subsequent diagnosis (13 I‐IMIDs). The I‐IMIDs most strongly associated with scleritis included granulomatosis with polyangiitis, Behçet’s disease, and Sjögren’s syndrome. Conclusion From 1997 through 2018, the UK incidence of scleritis declined from 4.23 to 2.79/100,000 person‐years. Incident scleritis was associated with 19 I‐IMIDs, providing data for rational investigation and cross‐specialty engagement.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

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Epidemiology of Scleritis in the United Kingdom From 1997 to 2018: Population‐Based Analysis of 11 Million Patients and Association Between Scleritis and Infectious and Immune‐Mediated Inflammatory Disease

Braithwaite

Adderley

Subramanian

et al. 2021

Arthritis & Rheumatology

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“…A cross-sectional study in California documented an incidence rate of 25.6 /100,000 person-years and prevalence rate of 69 cases/100,000 persons (22). However, infectious uveitis accounts for less than 20% of uveitis/ scleritis, with incidence rate of 18.9/100,000 and prevalence of 60.6/100,000 persons (23). Uveitis is classified as anterior, intermediate, posterior or pan uveitis depending on the anatomic location (24).…”

Section: Human Uveitismentioning

confidence: 99%

Uveitis: Molecular Pathogenesis and Emerging Therapies

2021

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The profound impact that vision loss has on human activities and quality of life necessitates understanding the etiology of potentially blinding diseases and their clinical management. The unique anatomic features of the eye and its sequestration from peripheral immune system also provides a framework for studying other diseases in immune privileged sites and validating basic immunological principles. Thus, early studies of intraocular inflammatory diseases (uveitis) were at the forefront of research on organ transplantation. These studies laid the groundwork for foundational discoveries on how immune system distinguishes self from non-self and established current concepts of acquired immune tolerance and autoimmunity. Our charge in this review is to examine how advances in molecular cell biology and immunology over the past 3 decades have contributed to the understanding of mechanisms that underlie immunopathogenesis of uveitis. Particular emphasis is on how advances in biotechnology have been leveraged in developing biologics and cell-based immunotherapies for uveitis and other neuroinflammatory diseases.

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“…Anterior NIU accounted for 81% (3,904 cases) in adults and 75% (207 cases) in pediatrics. Another claimbased analysis was conducted by Zhang et al 13 They used administrative insurance claims from 21.5 million privately insured individuals between 2007 and 2015 to estimate the prevalence of infectious uveitis and scleritis. The mean annual incidence and prevalence of infectious uveitis/scleritis were 18.9 and 60.6 per 100,000 persons, respectively.…”

Section: Types and Prevalence Of Uveitismentioning

confidence: 99%