Prevalence of the Uveitides in the United States

Jabs, Douglas A.

doi:10.1001/jamaophthalmol.2016.3289

Cited by 6 publications

(4 citation statements)

References 7 publications

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“…5 6 The prevalence of uveitis in the United States is estimated as 115-133 per 100 000. [7][8][9][10] Unlike the other common causes of visual impairment, such as cataract, age related macular degeneration, and glaucoma, the uveitides affect all age groups, including children, have the potential to result in visual impairment over a longer portion of the patient's lifetime, and have a much greater impact on years of potential vision lost. 11 Early diagnosis and proper treatment can prevent blindness and long term disability.…”

Section: Epidemiologymentioning

confidence: 99%

Uveitis for the non-ophthalmologist

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Jabs

2021

BMJ

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The uveitides are a heterogeneous group of diseases characterized by inflammation inside the eye. The uveitides are classified as infectious or non-infectious. The non-infectious uveitides, which are presumed to be immune mediated, can be further divided into those that are associated with a known systemic disease and those that are eye limited,—ie, not associated with a systemic disease. The ophthalmologist identifies the specific uveitic entity by medical history, clinical examination, and ocular imaging, as well as supplemental laboratory testing, if indicated. Treatment of the infectious uveitides is tailored to the particular infectious organism and may include regional and/or systemic medication. First line treatment for non-infectious uveitides is corticosteroids that can be administered topically, as regional injections or surgical implants, or systemically. Systemic immunosuppressive therapy is used in patients with severe disease who cannot tolerate corticosteroids, require chronic corticosteroids at >7.5 mg/day prednisone, or in whom the disease is known to respond better to immunosuppression. Management of many of these diseases is optimized by coordination between the ophthalmologist and rheumatologist or internist.

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Section: Epidemiologymentioning

confidence: 99%

Uveitis for the non-ophthalmologist

Burkholder

Jabs

2021

BMJ

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“…Conversely, most chronic, non-infectious uveitides need chronic treatment to suppress the inflammation. 1,12,13 For non-infectious uveitides, which comprise over 90% of the cases of uveitis in the United States, 3,4 the anatomic class guides the initial treatment approach. Anterior uveitides are treated with topical corticosteroids; intermediate uveitides with regional corticosteroid injections (either periocular or intravitreal) or oral corticosteroids and, when needed, immunosuppression; and posterior and panuveitides typically with oral corticosteroids and immunosuppression.…”

mentioning

confidence: 99%

Immunosuppression for the Uveitides

2018

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The uveitides are a collection of more than 30 diseases characterized by intraocular inflammation. Many cases of juvenile idiopathic arthritis-associated uveitis, many cases of intermediate uveitis, and most cases of posterior and panuveitides requiring treatment are treated with corticosteroids and immunosuppression. Disease-specific, time-updated modeling of clinical data for several uveitides suggests superior prevention of ocular complications and visual outcomes with immunosuppression. These studies also suggest that oral corticosteroids at doses low enough for safe long-term therapy (i.e., <7.5 mg/day) are ineffective, implying that immunosuppression should be part of the initial regimen. The Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study was a randomized comparative effectiveness trial comparing systemic therapy with oral corticosteroids and immunosuppression with regional corticosteroid treatment. It demonstrated that, when used properly, oral corticosteroids and immunosuppression can be given safely for up to 7 years with no evident increased risk of systemic side effects compared with regional corticosteroid therapy, except for greater antibiotic use for infections. The Systemic Treatment for Eye Diseases (SITE) Cohort Study suggested long-term safety for this approach, when the immunosuppressive agents were antimetabolites or calcineurin inhibitors. Thus, oral corticosteroids and immunosuppression may be a preferred initial therapy for many noninfectious, intermediate, posterior, and panuveitides. Nonalkylating-agent immunosuppression has a low rate of sustained, drug-free remissions, <10%/year. Nonalkylating-agent immunosuppression for >3 years with control of the inflammation for >2 years is associated with a decreased risk of relapse after discontinuing immunosuppression. Alkylating agents can induce sustained drug-free remissions but likely increase the lifetime risk of cancer. Biologics, which target specific cytokines and pathways, hold promise for the future. Monoclonal antibodies directed against tumor necrosis factor (TNF)-α have been studied most often, and one, adalimumab, is U.S. Food and Drug Administration approved for the treatment of noninfectious, intermediate, posterior, and panuveitides.

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“…[1] The prevalence of uveitis is estimated to approach 133 per 100 000. [2][3][4][5] Repeated active in ammation can irreversibly damage ocular structures and eventually cause signi cant deterioration in vision. [6] In addition, the majority of patients who suffer from uveitis are in their working age and it can cause signi cant decrease in productivity.…”

Section: Introductionmentioning

confidence: 99%

Patient Clinical Outcomes in Standalone Versus a Combined Ophthalmology-Rheumatology Uveitis Clinic

Ross

Habhab

Syeda

et al. 2022

Preprint

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Background: To evaluate uveitis care outcomes in standalone versus a combined ophthalmology-rheumatology clinic.Methods: Participants were patients aged 18 years and older with a minimum 12-month history of chronic uveitis prior to being referred to the combined uveitis clinic at Kresge Eye Institute and who were treated in the combined clinic for at least 6 months. Best corrected visual acuity (BCVA), objective markers of inflammation, and achieving targeted dose of immunomodulatory therapy (IMT) were compared in the cohort of uveitis patients 6 months prior to and after the initial evaluation in the combined clinic. Results: Sixty-six percent of study participants were female with a mean age of 51.5 years. BCVA improved from 0.58 logMAR (Snellen: ~20/74) at the initial combined clinic visit to 0.50 logMAR (Snellen: ~20/63) 6 months after the first combined visit (p=0.0137). The establishment of the combined uveitis clinic led to higher frequency of patients at target dose of IMT: an increase from 49.0% at 6 months prior to the combined visit to 70.1.4% and 79.8% at the initial combined visit and 6 months after the combined visit, respectively.Conclusion: A combined model of management for chronic uveitis patients wherein rheumatological services are coupled with ophthalmic care leads to improvement in patient clinical outcomes and achieving target therapy.

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Prevalence of the Uveitides in the United States

Cited by 6 publications

References 7 publications

Uveitis for the non-ophthalmologist

Uveitis for the non-ophthalmologist

Immunosuppression for the Uveitides

Patient Clinical Outcomes in Standalone Versus a Combined Ophthalmology-Rheumatology Uveitis Clinic

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