Elsevier

Ophthalmology

Volume 111, Issue 3, March 2004, Pages 491-500
Ophthalmology

Original article
Incidence and prevalence of uveitis in Northern California: The Northern California Epidemiology of Uveitis Study

Presented in part at: American Uveitis Society Meeting, American Academy of Ophthalmology Annual Meeting, October 23, 2000; Dallas. Published in part as an abstract (Gritz DC, Wong IG. Incidence of uveitis in a large managed care population: emphasis on children. Available at: http://www.uveitis.org/enhanced/abstracts/aus/aus_2000.htm). Presented in part at: American Academy of Ophthalmology and Pan American Association of Ophthalmology Joint Meeting, October 22, 2002; Orlando. Published as an abstract (Gritz DC, Wong IG. The Epidemiology of Uveitis Study: a large community-based population study in Northern California).
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Abstract

Purpose

To determine the incidence and prevalence of uveitis in a large, well-defined population in Northern California.

Design

Cross-sectional study using retrospective database and medical record review.

Participants

A group of 2070 people within 6 Northern California medical center communities (N = 731 898) who had a potential diagnosis of uveitis.

Methods

The patient database of a large health maintenance organization (2 805 443 members at time of the study) was searched for all patients who, during a 12-month period, had the potential diagnosis of uveitis. Detailed quarterly gender- and age-stratified population data were available. Medical records of patients who potentially had uveitis and who were members of the 6 target communities were reviewed by 2 uveitis subspecialists to confirm the diagnosis of uveitis and to establish time of onset. Demographic and clinical data were gathered for patients meeting the clinical definition of uveitis. Incidence rates were calculated by using a dynamic population model. Prevalence rates were based on the mid–study period population.

Main outcome measures

Presence and date of onset of uveitis.

Results

At midstudy, the population for the 6 communities was 731 898. During the target period, 382 new cases of uveitis were diagnosed; 462 cases of uveitis were diagnosed before the target period. These data yielded an incidence of 52.4/100 000 person-years and a period prevalence of 115.3/100 000 persons. The incidence and prevalence of disease were lowest in pediatric age groups and were highest in patients 65 years or older (P<0.0001). The prevalence of uveitis was higher in women than in men (P<0.001), but the difference in incidence between men and women was not statistically significant. Comparison between the group of patients who had onset of uveitis before the target period (ongoing uveitis) and the entire cohort of uveitis patients showed that women had a higher prevalence of ongoing uveitis than men and that this difference was largest in the older age groups (P<0.001).

Conclusion

In this largest population-based uveitis study in the United States to date, the incidence of uveitis was approximately 3 times that of previous U.S. estimates and increased with the increasing age of patients. Women had a higher prevalence of uveitis than men, and the largest differences were in older age groups.

Section snippets

Study design

This cross-sectional study used retrospective database and medical record review.

Study objectives

The purposes of this study were to (1) calculate incidence and prevalence of endogenous uveitis in the target population overall and stratified by gender and age; (2) calculate incidence and prevalence of different categories of uveitis by using the International Uveitis Study Group terminology for the target population overall and stratified by gender and age; and (3) compare results from this study with the

Results

The midterm study population of the 6 communities consisted of 731 895 patients, whose demographic characteristics are shown in Table 2 and whose age- and gender-stratified population data are shown in Table 3.

During the study period, 6452 patients in the KP Northern California Region received target diagnoses at least once. Of these patients, 2070 were members of the 6 study communities. These patients were seen at 21 separate outpatient eye clinics. Some of these patients were seen initially

Discussion

This population-based study of the epidemiology of uveitis is the largest of its kind to be performed. The findings contrast sharply with the only previous U.S. population-based study2 of the incidence and prevalence of uveitis. The present study found a much higher incidence and prevalence of disease and a peak in rate of disease with older age compared with a peak in rate of disease in the middle adult years, a result reported in Darrell and associates' Minnesota study.2

Table 8 shows other

Acknowledgements

Bruce Fireman, MA, assisted with advice on biostatistical analysis, and B. Michael Kamen, BSIE, RN, assisted in analysis of outpatient diagnoses and database design. Tracy Lee, CCS, CCS-P, assisted with Outpatient Services Clinical Records code citation. The Medical Editing Department, Kaiser Foundation Research Institute, provided editorial assistance.

References (14)

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Manuscript no. 220650.

Funding for the study was provided by a Permanente Medical Group Innovations Grant and a grant from the Kaiser Permanente Community Benefit Program.

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