gms | German Medical Science

Uveitis as a diagnosis may conceal an underlying systemic disease, an infection or an ocular syndrome. Studies on the epidemiology of such secondary forms of uveitis are rare. This study aimed to analyze the frequencies of such secondary forms based on patients' visits to the uveitis office hours of a tertiary referral center.

This retrospective study included 893 patients (median age 42 yrs.; range 1 - 89yrs.) with verified uveitis who presented at the Interdisciplinary Uveitis Center of the University of Heidelberg between October 2001 and March 2004. All patients were entered systematically into an electronic database, which served as a digital patient's record. The analysis was performed with regards to the following parameters: underlying systemic disease, infection, ocular syndrome, laterality and anatomical location.

In 58% of patients, secondary uveitis was observed. Male patients (45% of all patients) showed more often signs of secondary uveitis than female patients (62% vs. 54%). Secondary uveitis was found in the following proportions: underlying systemic disease was found in 28% of patients, the most frequent ones being ankylosing spondylitis (5%) and sarcoidosis (4%). Infections were found in 10% of patients, the most frequent ones being toxoplasmosis (3%) and herpetic uveitis (2%). Ocular syndromes were found in 19% of patients, the most frequent ones being Fuchs' uveitis syndrome (7%) and HLA-B27-positive anterior uveitis (5%). If patients showed unilateral uveitis (45%), 61% of cases showed secondary uveitis. If patients showed bilateral uveitis, 55% of patients showed secondary uveitis. In 42% of patients an anterior uveitis was found, in 15% an intermediate uveitis and in 16% a posterior uveitis. The remaining 12% of cases were distributed among extrauveal manifestations such as scleritis, episcleritis, neuritis, myositis and orbital inflammation.

Knowledge of the epidemiology of secondary uveitis is important for rational diagnostics. The high frequency of secondary uveitis shows that an interdisciplinary approach to uveitis is of great importance.