REFERRAL PATTERNS OF UVEITIS IN A TERTIARY EYE CARE CENTER

Objective: To analyze the referral patterns and diagnosis of uveitis d uring the past decade in a large tertiary eye center. Design: The reco rds of 1237 patients with uveitis referred to the Immunology Service o f the Massachusetts Eye and Ear Infirmary from 1982 to 1992 were class ified and analyzed. Data regarding sex, race, nationality, referral si te, ages at presentation and onset of uveitis, ocular involvement, cli nical characteristics, ocular condition, and systemic disease associat ions were obtained. Results: The mean age at onset of uveitis was 37.2 years; the male-to-female ratio was 1:1.4. Most patients were white ( 85.8%), born in the United States (83.1%), and referred from within Ne w England (84.7%). Anterior uveitis was most common (51.6%), followed by posterior uveitis (19.4%), panuveitis (16.0%), and intermediate uve itis (13.0%). Chronic (58.3%), nongranulomatous (77.7%), and noninfect ious (83.1%) were the most frequent types of uveitis. The most common entities included idiopathic (34.9%), seronegative spondyloarthropathi es (10.4%), sarcoidosis (9.6%), juvenile rheumatoid arthritis (5.6%), systemic lupus erythematosus (4.8%), Behcet's disease (2.5%), and the acquired immunodeficiency syndrome (2.4%). Conclusion: The appearance of new uveitic entities, such as the acute retinal necrosis syndrome, multifocal choroiditis and panuveitis, birdshot retinochoroidopathy, a nd acquired immunodeficiency syndrome-related uveitis, and the reemerg ence of the classic infectious causes of uveitis, tuberculosis and syp hilis, have changed the way we approach the diagnosis and management o f posterior and panuveitis at the Massachusetts Eye and Ear Infirmary.