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Association between temperature changes and uveitis onset in mainland China
  1. Handan Tan1,
  2. Su Pan1,
  3. Zhenyu Zhong1,
  4. Jing Shi1,
  5. Weiting Liao1,
  6. Guannan Su1,
  7. Aize Kijlstra2,
  8. Peizeng Yang1
  1. 1 The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, chongqing, China
  2. 2 University Eye Clinic Maastricht, Maastricht, Limburg, the Netherlands, Maastricht, Netherlands
  1. Correspondence to Peizeng Yang, The First Affiliated Hospital of Chongqing Medical University, Youyi Road 1, Chongqing 400016, P.R. China; peizengycmu{at}


Background Some uveitis subtypes show seasonal patterns. Whether these patterns are caused by seasonally varying temperatures or by other climatic factors remains unknown. This ecological research aimed to quantify the association between climate variability and uveitis onset.

Methods We combined data from the largest database of uveitis cases with surface climate data to construct panel data. We used choropleth maps to visually assess spatial uveitis variations.

Results Among 12 721 reports of uveitis originating from 31 provinces of mainland China from 2006 to 2017, we found that a 1°C increase in monthly temperature was associated with a rise in approximately 2 uveitis reports per 1000 individuals (95% CI 0.00059 to 0.0029). This association was present across all provinces, ranging in effect size from 0.0011 to 0.072 (95% CI 0.00037 to 0.10). A clear 0–3 months of cumulative lagging effect was noted across all types of uveitis, with the strongest effect for non-infectious uveitis (0.0067, 95% CI 0.0041 to 0.013). Stratified by age and sex, we found that men and people aged 20–50 years were more affected by temperature variations. Our model predicts that China might experience an increase in uveitis cases due to future global warming.

Conclusion Our study is the largest-ever investigation of the association between uveitis and climate and, for the first time, provides evidence that rising temperature can affect large-scale uveitis onset. These results may help promote and implement policies to mitigate future temperature increases and the burden of disease caused by global warming.

  • Epidemiology
  • Eye (Globe)
  • Public health

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  • HT and SP contributed equally to this work.

  • Contributors PY and HT conceived and designed the study. HT, SP, ZZ, JS and WL collected clinical data. HT and SP analysed and interpreted the data. HT wrote the first draft of the paper. PY, GS and KA reviewed and edited the manuscript. All authors provided a final review and approved the manuscript before submission.

  • Funding This study was supported by Chongqing Outstanding Scientists Project (2019), Chongqing Key Laboratory of Ophthalmology (CSTC, 2008CA5003), Chongqing Science & Technology Platform and Base Construction Program (cstc2014pt-sy10002) and the Chongqing Chief Medical Scientist Project (2018).

  • Map disclaimer The depiction of boundaries on the map(s) in this article does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

  • Competing interests None declared.

  • Ethics approval The experimental procedures and research design were conducted in accordance with the tenets of the Declaration of Helsinki. The Clinical Research Ethics Committee of the First Affiliated Hospital of Chongqing Medical University approved this study and waived the need for informed consent based on the retrospective nature of the study and anonymisation of the data.

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

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplemental information.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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