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Age-related macular degeneration in patients with uveitis
  1. Austin R Fox1,
  2. Emily Y Chew1,
  3. Catherine Meyerle2,
  4. Susan Vitale1,
  5. Frederick L Ferris1,
  6. Robert B Nussenblatt1,
  7. H Nida Sen1
  1. 1National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA
  2. 2Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr H Nida Sen, National Eye Institute, National Institutes of Health, 10 Center Drive 10D45, Bethesda, MD 20892, USA; senh{at}nei.nih.gov

Abstract

Purpose To evaluate the prevalence of large drusen in a uveitis clinic population.

Design Retrospective, cohort study.

Methods Patients with primary, non-infectious uveitis 55 years or older who were seen at the National Eye Institute of the National Institutes of Health from 2004 through August 2013 were reviewed using electronic medical records and photographic databases. Patients were classified as having age-related macular degeneration (AMD) if either eye had large drusen, geographic atrophy or neovascular AMD according to definitions used by the Eye Diseases Prevalence Research Group (EDPRG). The expected number of cases and standardised mortality ratio (SMR) for large drusen were estimated based on EDPRG estimates.

Results We identified 177 patients aged ≥55 years as having primary non-infectious uveitis; 170 (96.0%) had gradable fundus photos. Average age was 65.0±7.5 years (range 55–87), and 87 were non-Hispanic white, 66 non-Hispanic black, 6 Hispanic white and 11 of other race/ethnicity. Large drusen were identified in four patients (2.4%; 95% CI 0.6 to 6.0). No patients were identified to have late AMD. In the uveitis cohort, the SMR for cases of large drusen, which was adjusted for age, was calculated to be 0.32 (95% CI 0.12 to 0.70) for the whole cohort, 0.28 (95% CI 0.09 to 0.79) for non-Hispanic whites and 0.46 (95% CI 0.14 to 1.29) for non-Hispanic blacks.

Conclusions Large drusen prevalence among patients with uveitis ≥55 years of age appears less than the prevalence in the general US population after accounting for differences in age distribution, especially for non-Hispanic whites. Although the racial and gender distribution in this study population is not directly representative of the general US population, results of this study suggest possible sparing of patients with uveitis from AMD. A larger systematic study with greater power would be needed to confirm these findings.

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Footnotes

  • Contributors ARF contributed to the conception or design of the study, data collection, analysis and interpretation of findings, statistical expertise, obtaining funding, literature search, administrative support, writing the manuscript and final approval of the manuscript. EYC contributed to the conception or design of the study, analysis and interpretation of findings, statistical expertise, literature search, critical revision of the manuscript and final approval of the manuscript. CM contributed to the conception or design of the study, data collection, analysis and interpretation of findings, literature search, critical revision of the manuscript and final approval of the manuscript. SV contributed to the conception or design of the study, data collection, analysis and interpretation of findings, statistical expertise, literature search, administrative support, writing and critical revision of the manuscript and final approval of the manuscript. FLF contributed to the conception or design of the study, analysis and interpretation of findings, statistical expertise, obtaining funding, literature search, critical revision of the manuscript and final approval of the manuscript. RBN contributed to the conception or design of the study, analysis and interpretation of findings, statistical expertise, literature search, obtaining funding, administrative support, provision of patients and resources, critical revision of the manuscript and final approval of the manuscript. HNS contributed to the conception or design of the study, data collection, analysis and interpretation of findings, statistical expertise, literature search, obtaining funding, administrative support, provision of patients and resources, writing and critical revision of the manuscript and final approval of the manuscript.

  • Funding This work is supported by the NEI Intramural Research Program and the NIH Medical Research Scholars Program. The NIH Medical Research Scholars Program is a public–private partnership supported jointly by the NIH and generous contributions to the Foundation for the NIH from Pfizer, the Doris Duke Charitable Foundation, the Newport Foundation, the American Association for Dental Research, the Howard Hughes Medical Institute and the Colgate-Palmolive Company, as well as other private donors. For a complete list, please visit the Foundation website at http://fnih.org/work/education-training-0/medical-research-scholars-program.

  • Competing interests None declared.

  • Ethics approval The Office of Human Subjects Research, National Institutes of Health.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Both the first and senior authors had full access to all the data in the study. Additional available data are included in online supplementary material.

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