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Global issues
Population-based prevalence of uveitis in Southern India
  1. Sivakumar R Rathinam1,2,
  2. Ramasamy Krishnadas1,2,
  3. Rengapa Ramakrishnan2,4,
  4. Ravilla D Thulasiraj2,3,
  5. James M Tielsch5,6,7,
  6. Joanne Katz5,6,
  7. Alan L Robin6,7,
  8. John H Kempen8,9,10,
  9. for the Aravind Comprehensive Eye Survey Research Group
  1. 1The Aravind Eye Hospital and Post-Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
  2. 2The G. Venkataswamy Eye Research Institute, Madurai, Tamil Nadu, India
  3. 3The Lions Aravind Institute of Community Ophthalmology, Madurai, Tamil Nadu, India
  4. 4The Aravind Eye Hospital, Tirunelveli, Tirunelveli, Tamil Nadu, India
  5. 5The Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  6. 6Department of International Health, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  7. 7Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  8. 8The Ocular Inflammation Service, Scheie Eye Institute, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
  9. 9The Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
  10. 10The Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics & Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr John H Kempen, 3535 Market Street, Suite 700, Philadelphia, PA 19104, USA; john.kempen{at}uphs.upenn.edu

Purpose To estimate the prevalence of uveitis in rural Tamil Nadu, India.

Methods Cluster sampling identified a population-based sample of 5150 persons ages 40 years and older, representative of three districts in Tamil Nadu, India. Each received a comprehensive dilated ocular examination by an ophthalmologist, and results were registered on forms requiring responses about the presence of ocular inflammatory signs and inflammatory diagnoses. Potential uveitis cases were confirmed by consensus of two uveitis specialists, upon review of study and medical records. Crude prevalence rates and prevalence rates age-adjusted to reflect the 2001 Tamil Nadu census population were calculated.

Results Crude and age-adjusted prevalence rates for endogenous uveitis were 310/100 000 and 317/100 000. The corresponding rates for all ocular inflammation were 450 and 467/100 000. Males tended to have a greater prevalence than females in this population, and older persons tended to have higher prevalence than younger persons. The majority of cases of posterior uveitis and infectious endophthalmitis were visually compromised, but few among the cases of other forms of ocular inflammation were visually impaired.

Conclusions The results suggest that nearly one in 200 persons in rural, South India has been affected by ocular inflammation in at least one eye by mid to late adulthood, about one in 330 if cases related to surgery or trauma are not included. Postsurgical endophthalmitis and posterior uveitis were associated with a high rate of vision loss. These results indicate that uveitis is an important cause of ocular morbidity and of vision loss in this population.

  • Uveitis
  • prevalence
  • blindness
  • low vision
  • epidemiology
  • inflammation

http://dx.doi.org/10.1136/bjo.2010.182311

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    Purpose To estimate the prevalence of uveitis in rural Tamil Nadu, India.

    Methods Cluster sampling identified a population-based sample of 5150 persons ages 40 years and older, representative of three districts in Tamil Nadu, India. Each received a comprehensive dilated ocular examination by an ophthalmologist, and results were registered on forms requiring responses about the presence of ocular inflammatory signs and inflammatory diagnoses. Potential uveitis cases were confirmed by consensus of two uveitis specialists, upon review of study and medical records. Crude prevalence rates and prevalence rates age-adjusted to reflect the 2001 Tamil Nadu census population were calculated.

    Results Crude and age-adjusted prevalence rates for endogenous uveitis were 310/100 000 and 317/100 000. The corresponding rates for all ocular inflammation were 450 and 467/100 000. Males tended to have a greater prevalence than females in this population, and older persons tended to have higher prevalence than younger persons. The majority of cases of posterior uveitis and infectious endophthalmitis were visually compromised, but few among the cases of other forms of ocular inflammation were visually impaired.

    Conclusions The results suggest that nearly one in 200 persons in rural, South India has been affected by ocular inflammation in at least one eye by mid to late adulthood, about one in 330 if cases related to surgery or trauma are not included. Postsurgical endophthalmitis and posterior uveitis were associated with a high rate of vision loss. These results indicate that uveitis is an important cause of ocular morbidity and of vision loss in this population.

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    Footnotes

    • Funding This study was supported in part by unrestricted grants from Allergan, Inc, Alcon Laboratories, Inc, and Zeiss Corp. Additional support was obtained from NEI grant EY00386 (Dr Kempen), the Paul and Evanina Mackall Foundation, and Research to Prevent Blindness (RPB). JHK is a James S Adams RPB Special Scholar.

    • Competing interests None.

    • Ethics approval Ethics approval was provided by the Aravind Hospital System Ethics Committee; Bloomberg School of Public Health, Johns Hopkins University.

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