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Analysis of new cases of uveitis at academic and community settings
  1. Meghan Berkenstock1,
  2. Renuka Mopuru1,
  3. Jennifer Thorne1,
  4. Adrienne Willams Scott2
  1. 1Ocular Immunology Division, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA
  2. 2Retina Division, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA
  1. Correspondence to Meghan Berkenstock, Johns Hopkins Wilmer Eye Institute, 600 N. Wolfe St., Maumenee 3rd Floor, Baltimore, MD 21287-0010, USA; mberken2{at}jh.edu

Abstract

Purpose Describe the demographics of new patients with uveitis presenting to an urban, academic centre and affiliated, suburban satellite clinics to assess if changes in infrastructure were needed for clinical care. Secondarily, examine the frequency of infectious uveitides.

Methods A retrospective chart review of single academic centre of 436 consecutive, new patients with uveitis (686 eyes) and 3 affiliated, satellite clinics seen by 8 uveitis specialists from 1 July 2013 to 31 March 2017. Demographics recorded included patient age, race, associated systemic disease, uveitis chronicity, and anatomic location. The main outcome measure was comparing frequencies of patient demographics, immunosuppressive agent use, and infectious uveitis between locations.

Results 366 patients (587 eyes) were evaluated at the academic clinic and 70 (99 eyes) at the satellite locations. Anterior uveitis was the most common anatomic location; more acute, unilateral cases were seen at satellites (p=0.007; p=0.002, respectively). A larger percentage of posterior and panuveitis cases presented to the academic centre (p<0.0001). There was no difference in systemic disease association (p=0.925) or infectious uveitis cases (p=0.956). The use of non-corticosteroid immunosuppressive medications was higher at the academic clinic (p<0.001).

Conclusions Anterior uveitis comprised the majority of cases in both clinics. Non-corticosteroid immunosuppressive agents were used more frequently at the academic clinic, reflecting more cases of chronic posterior and panuveitis. Compounded intravitreal injections, specialised ophthalmic imaging studies and high-risk medication monitoring can be centralised in the academic clinic. Infectious uveitis cases were seen at both locations, with an increase in syphilis diagnoses at the academic centre.

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Footnotes

  • Contributors All authors have participated in review and editing of the manuscript. MB designed the study, collected the data, analysed the data, and wrote the manuscript. RM helped analyse the data. All authors are responsible for the data integrity.

  • Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

  • 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 supplementary 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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