Giuseppe Lopalco1, Vincenzo Venerito1, Jurgen Sota2, Donato Rigante3, Silvana Guerriero4, Ida Orlando2, Rossella Franceschini5, Rossella Favale4, Giovanni Lapadula1, Barbara Castelli3, Bruno Frediani2, Mauro Galeazzi2, Francesco La Torre6, Florenzo Iannone1, Gian Marco Tosi5, Claudia Fabiani7, Luca Cantarini8. 1. Department of Emergency and Organ Transplantation, Rheumatology Unit, University of Bari, Italy. 2. Research Centre of Systemic Autoinflammatory Diseases and Behçet's Disease and Rheumatology-Ophthalmology Collaborative Uveitis Centre, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy. 3. Institute of Paediatrics, Università Cattolica Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy. 4. Department of Ophthalmology and Otolaryngology, University of Bari, Italy. 5. Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy. 6. Paediatric Rheumatology Section, Paediatric Oncoematology Unit, Vito Fazzi Hospital, Lecce, Italy. 7. Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, and Department of Ophthalmology, Humanitas Clinical and Research Centre, Rozzano (Milan), Italy. claudia.fabiani@gmail.com. 8. Research Centre of Systemic Autoinflammatory Diseases and Behçet's Disease and Rheumatology-Ophthalmology Collaborative Uveitis Centre, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy. cantariniluca@hotmail.com.
Abstract
OBJECTIVES: To describe the epidemiology of non-infectious uveitis (NIU) in two tertiary referral rheumatology units in Central and Southern Italy. METHODS: Two hundred and seventy-eight consecutive NIU patients (417 eyes) evaluated between January 2016 and January 2017 were enrolled. Collected data were analysed in accordance with the primary anatomic site of inflammation, clinical course, and laterality. RESULTS: The mean age at NIU onset was 36.92±18.30 years with a female-to-male ratio of 1.34:1. Anterior uveitis (AU) was identified in 151 (54.32%), posterior uveitis (PU) in 67 (24.10%), intermediate uveitis (IU) in 5.40% and panuveitis (PanU) in 16.19% patients. Bilateral involvement was identified in 50% of our cohort. Uveitis was acute in 33.81% of patients, while 24.46% and 41.73% had a chronic and recurrent course, respectively. Gender and laterality did not influence the anatomical pattern, while disease course was significantly more acute or chronic in AU (p<0.05) and chronic in IU (p<0.05). An associated systemic disease was identified in 116 patients (41.73%). Twenty-seven patients (9.7%) had a specific isolated eye disease, 135 patients (48.56%) had idiopathic NIU. Uveitis associated with a systemic disease was significantly bilateral (p=0.01) and acute or chronic (p<0.0001), while the isolated form showed an association with chronic course (p<0.0001) and unilaterality (p=0.01). CONCLUSIONS: The most common anatomic pattern of NIU has been AU, followed by PU, PanU and IU. A systemic disease (mainly Behçet's disease, ankylosing spondylitis and juvenile idiopathic arthritis) has been recognised in a fair proportion of the entire cohort. The rheumatologist should remain a central professional figure in the multidisciplinary team dealing with intraocular inflammation on a daily basis.
OBJECTIVES: To describe the epidemiology of non-infectious uveitis (NIU) in two tertiary referral rheumatology units in Central and Southern Italy. METHODS: Two hundred and seventy-eight consecutive NIU patients (417 eyes) evaluated between January 2016 and January 2017 were enrolled. Collected data were analysed in accordance with the primary anatomic site of inflammation, clinical course, and laterality. RESULTS: The mean age at NIU onset was 36.92±18.30 years with a female-to-male ratio of 1.34:1. Anterior uveitis (AU) was identified in 151 (54.32%), posterior uveitis (PU) in 67 (24.10%), intermediate uveitis (IU) in 5.40% and panuveitis (PanU) in 16.19% patients. Bilateral involvement was identified in 50% of our cohort. Uveitis was acute in 33.81% of patients, while 24.46% and 41.73% had a chronic and recurrent course, respectively. Gender and laterality did not influence the anatomical pattern, while disease course was significantly more acute or chronic in AU (p<0.05) and chronic in IU (p<0.05). An associated systemic disease was identified in 116 patients (41.73%). Twenty-seven patients (9.7%) had a specific isolated eye disease, 135 patients (48.56%) had idiopathic NIU. Uveitis associated with a systemic disease was significantly bilateral (p=0.01) and acute or chronic (p<0.0001), while the isolated form showed an association with chronic course (p<0.0001) and unilaterality (p=0.01). CONCLUSIONS: The most common anatomic pattern of NIU has been AU, followed by PU, PanU and IU. A systemic disease (mainly Behçet's disease, ankylosing spondylitis and juvenile idiopathic arthritis) has been recognised in a fair proportion of the entire cohort. The rheumatologist should remain a central professional figure in the multidisciplinary team dealing with intraocular inflammation on a daily basis.