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Review of de novo uveitis in older adults presenting to a large tertiary centre
  1. Priya Samalia1,2,
  2. Luke Jeffrey Hawley3,
  3. Rachael L Niederer1,
  4. Joanne Sims1
  1. 1Ophthalmology, Greenlane Clinical Centre, Auckland, New Zealand
  2. 2Ophthalmology, The University of Auckland Department of Ophthalmology, Auckland, New Zealand
  3. 3Auckland City Hospital, Auckland, New Zealand
  1. Correspondence to Priya Samalia, Ophthalmology, Greenlane Clinical Centre, Auckland 1051, New Zealand; dr.priyasamalia{at}gmail.com

Abstract

Background/aims The primary aim of this study was to describe the causes of de novo uveitis in individuals 60 years and older. Secondary objectives were to determine the incidence of intraocular lymphoma and the clinical predictors of lymphoma.

Methods Retrospective chart review of all subjects presenting to the uveitis service at Auckland District Health Board (Auckland, New Zealand) between January 2006 and October 2020

Results 686 subjects (900 eyes) were aged ≥60 years at first presentation with uveitis, representing 23.4% of all subjects with uveitis during the study period. Non-infectious aetiology occurred in 631 (70.1%) eyes and infectious etiologies occurred in 269 (29.9%) eyes. The most frequent causes were idiopathic (36.3%), herpes zoster (14.8%), HLAB27 (8.7%) and sarcoidosis (4.8%). Twenty (2.2%) eyes of 13 (1.9%) subjects had a diagnosis of lymphoma. Lymphoma represented 11.2% of all intermediate uveitis. Subjects diagnosed with lymphoma did not develop posterior synechiae, epiretinal membrane, cystoid macular oedema or ocular hypertension.

Conclusions Intraocular lymphoma was uncommon in the overall cohort, but an important cause of intermediate uveitis. A diagnosis of lymphoma needs to be considered in any older subject with de novo intermediate uveitis. The lack of posterior synechiae, cystoid macular oedema, epiretinal membrane and ocular hypertension further increases the suspicion for lymphoma.

  • neoplasia
  • immunology
  • infection
  • inflammation

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Footnotes

  • Contributors JS and RLN conceived of the presented idea. JS, RLN and PS verified the analytical methods. JS and RLN encouraged PS and LJH to investigate and collect retrospective data and supervised the findings of this work. All authors discussed the results and contributed to the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study received ethics approval from the Auckland District Health Board Review Committee (AH1339) and adhered to the tenets of the Declaration of Helsinki.

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

  • Data availability statement No data are available.

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