Systemic association of uveitis in Nepalese population

Abstract

Background: Infectious diseases are very common in Nepal and almost all infections are capable of causing uveitis. Parasitic infestations affect large number of Nepalese population and any parasitic infestation can potentially lead to development of uveitis. Local and systemic viral infections, immunological disorder like autoimmune diseases and malignancies can lead to uveitis. All these emphasize the necessity of proper systemic evaluation and investigation to identify the underlying systemic illness causing uveitis in order to see the pattern of systemic illness and determine the commonest associated systemic disease with uveitis. Methods: A prospective study was conducted at BP Koirala Lions Centre for Ophthalmic Studies from November 2008 to April 2010. All the patients underwent a standard diagnostic protocol when indicated by special tests and procedures performed in order of likelihood. Results: A total of 308 patients with uveitis was seen during the study period. For 146 (47.4%) patients, a specific diagnosis was established based on history, ocular examination and laboratory investigations. A definite association with systemic disease was determined for 82 (26.6%) patients. A well established clinical uveitis entity without a recognizable systemic disorder was present in 64 (20.8%) cases. A diagnosis could not be established in 162 (52.6%) cases. Toxoplasmosis was found to be most frequently associated with uveitis accounting for 5.8 % of the total cases followed by tuberculosis (3.6%), herpes infections (3%), ankylosing spondylitis (2.9%), leprosy (2.3%), sarcoidosis (1.6%) and parasitic infestations (1.3%). Conclusion: The importance of relevant systemic work up in uveitis cases in our set up has been reemphasized by the present study.

Patterns of Uveitis among Nepalese population Presenting at a Tertiary Referral Eye Care Centre in Nepal

“…However, intermediate uveitis was the manifesting feature of three of our syphilis case. Other associated conditions were tuberculosis, sarcoidosis, and leprosy which has also been reported in various other studies [17,19,33,46,47]. None of the patients of the intermediate uveitis group were diagnosed with multiple sclerosis or lymphoma.…”

“…The percentage of infectious causes in our series (24.27%) is between the values described in developed countries (11-21%) and those of developing countries (30-50%) [16,17]. In a study from India, the predominant infectious uveitis include leptospirosis (9.7%), tuberculosis (5.6%) and herpetic disorders (4.9%) [33].…”

“…In this study, 5813 eyes of 4359 patients meeting the inclusion criteria were included. There was a very slight female preponderance, however, the previous report from Nepal showed equal distribution [16][17][18]. Some reports from South India have also suggested this trend with an increase in female preponderance from 36% to 44% [19].…”

“…Among, noninfectious diseases, RA and sarcoidosis were common systemic disorders. In the previous report from Nepal, ankylosing spondylitis, VKH, and sarcoidosis were common [16,17]. Likewise, VKH, HLAB27 related disorder, and diabetic associated uveitis were common in Chile 37 and India [21,33].…”

Rare Case of Sarcoidosis Presenting As Bilateral Iridocyclitis

“…A previous study in a tertiary hospital in Kathmandu shows it is a significant disease to consider, particularly noting the symptomatology closely resembles tuberculosis. Regarding ocular morbidity, a study had been done at a tertiary eye hospital in Kathmandu (November 2008-April 2010) to find systemic associations of uveitis [7]. This study reported sarcoidosis to be a cause of 1.6% of the total cases (308) investigated.…”