Infectious uveitis in virginia

Stephanie B. Engelhard, Zeina Haddad, Asima Bajwa, James Patrie, Wenjun Xin, Ashvini Reddy

Research output: Contribution to journalArticle

Abstract

Purpose: To report the causes, clinical features, and outcomes of infectious uveitis in patients managed in a mid-Atlantic tertiary care center. Methods: Retrospective, observational study of infectious uveitis patients seen at the University of Virginia from 1984 to 2014. Results: Seventy-seven of 491 patients (15.7%) were diagnosed with infectious uveitis (mean age 58 years, 71.4% female, 76.6% Caucasian). The mean follow-up was 5 years. Anterior uveitis was the most common anatomic classification (39 patients, 50.6%) followed by panuveitis (20 patients, 26.0%) and posterior uveitis (18 patients, 23.4%). The most common infectious etiology was herpetic anterior uveitis (37 patients, 48.1%) followed by toxoplasma uveitis (14 patients, 18.2%). The most prevalent viral pathogen was varicella-zoster virus (21 patients, 27.3%) followed by herpes simplex virus (20 patients, 26.0%). Acute retinal necrosis (ARN) was diagnosed in 14 patients (18.2%). Aqueous humor yielded an etiologic diagnosis in seven (50%) of ARN patients, four of whom tested positive for cytomegalovirus and three for varicella-zoster virus. On presentation, 43 patients (55.8%) had a visual acuity (VA) better than 20/40 and 17 (22.1%) had a VA worse than 20/200. VA at the final follow-up was better than 20/40 in 39 patients (50.6%) and worse than 20/200 in 22 patients (28.6%). In all, 16 (20.8%) and 10 (13.0%) patients required cataract and vitrectomy surgery, respectively. A total of 14 patients (18.2%) were on glaucoma topical treatment and four (5.2%) required glaucoma surgery. Conclusion: The most common type of infectious uveitis seen over the study period was herpetic anterior uveitis secondary to varicella-zoster virus or herpes simplex virus, found to be most prevalent in patients over 60 years of age. This finding is comparable to other American epidemiologic studies. Ocular toxoplasmosis and ARN were also common causes of infectious uveitis. In all, 50.6% of patients had a VA better than 20/40 at the final follow-up visit, indicating the importance of prompt referral and appropriate treatment.

Original languageEnglish (US)
Pages (from-to)1589-1594
Number of pages6
JournalClinical Ophthalmology
Volume9
DOIs
StatePublished - Aug 28 2015
Externally publishedYes

Fingerprint

Uveitis
Acute Retinal Necrosis Syndrome
Anterior Uveitis
Visual Acuity
Human Herpesvirus 3
Simplexvirus
Glaucoma
Ocular Toxoplasmosis
Panuveitis
Posterior Uveitis
Aqueous Humor
Vitrectomy
Toxoplasma

Keywords

  • Chorioretinitis
  • Endophthalmitis
  • Infectious
  • Toxoplasma
  • Uveitis

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Engelhard, S. B., Haddad, Z., Bajwa, A., Patrie, J., Xin, W., & Reddy, A. (2015). Infectious uveitis in virginia. Clinical Ophthalmology, 9, 1589-1594. https://doi.org/10.2147/OPTH.S86578

Infectious uveitis in virginia. / Engelhard, Stephanie B.; Haddad, Zeina; Bajwa, Asima; Patrie, James; Xin, Wenjun; Reddy, Ashvini.

In: Clinical Ophthalmology, Vol. 9, 28.08.2015, p. 1589-1594.

Research output: Contribution to journalArticle

Engelhard, SB, Haddad, Z, Bajwa, A, Patrie, J, Xin, W & Reddy, A 2015, 'Infectious uveitis in virginia', Clinical Ophthalmology, vol. 9, pp. 1589-1594. https://doi.org/10.2147/OPTH.S86578
Engelhard SB, Haddad Z, Bajwa A, Patrie J, Xin W, Reddy A. Infectious uveitis in virginia. Clinical Ophthalmology. 2015 Aug 28;9:1589-1594. https://doi.org/10.2147/OPTH.S86578
Engelhard, Stephanie B. ; Haddad, Zeina ; Bajwa, Asima ; Patrie, James ; Xin, Wenjun ; Reddy, Ashvini. / Infectious uveitis in virginia. In: Clinical Ophthalmology. 2015 ; Vol. 9. pp. 1589-1594.
@article{a23e307d93c44044af9c29cacd2bd6b4,
title = "Infectious uveitis in virginia",
abstract = "Purpose: To report the causes, clinical features, and outcomes of infectious uveitis in patients managed in a mid-Atlantic tertiary care center. Methods: Retrospective, observational study of infectious uveitis patients seen at the University of Virginia from 1984 to 2014. Results: Seventy-seven of 491 patients (15.7{\%}) were diagnosed with infectious uveitis (mean age 58 years, 71.4{\%} female, 76.6{\%} Caucasian). The mean follow-up was 5 years. Anterior uveitis was the most common anatomic classification (39 patients, 50.6{\%}) followed by panuveitis (20 patients, 26.0{\%}) and posterior uveitis (18 patients, 23.4{\%}). The most common infectious etiology was herpetic anterior uveitis (37 patients, 48.1{\%}) followed by toxoplasma uveitis (14 patients, 18.2{\%}). The most prevalent viral pathogen was varicella-zoster virus (21 patients, 27.3{\%}) followed by herpes simplex virus (20 patients, 26.0{\%}). Acute retinal necrosis (ARN) was diagnosed in 14 patients (18.2{\%}). Aqueous humor yielded an etiologic diagnosis in seven (50{\%}) of ARN patients, four of whom tested positive for cytomegalovirus and three for varicella-zoster virus. On presentation, 43 patients (55.8{\%}) had a visual acuity (VA) better than 20/40 and 17 (22.1{\%}) had a VA worse than 20/200. VA at the final follow-up was better than 20/40 in 39 patients (50.6{\%}) and worse than 20/200 in 22 patients (28.6{\%}). In all, 16 (20.8{\%}) and 10 (13.0{\%}) patients required cataract and vitrectomy surgery, respectively. A total of 14 patients (18.2{\%}) were on glaucoma topical treatment and four (5.2{\%}) required glaucoma surgery. Conclusion: The most common type of infectious uveitis seen over the study period was herpetic anterior uveitis secondary to varicella-zoster virus or herpes simplex virus, found to be most prevalent in patients over 60 years of age. This finding is comparable to other American epidemiologic studies. Ocular toxoplasmosis and ARN were also common causes of infectious uveitis. In all, 50.6{\%} of patients had a VA better than 20/40 at the final follow-up visit, indicating the importance of prompt referral and appropriate treatment.",
keywords = "Chorioretinitis, Endophthalmitis, Infectious, Toxoplasma, Uveitis",
author = "Engelhard, {Stephanie B.} and Zeina Haddad and Asima Bajwa and James Patrie and Wenjun Xin and Ashvini Reddy",
year = "2015",
month = "8",
day = "28",
doi = "10.2147/OPTH.S86578",
language = "English (US)",
volume = "9",
pages = "1589--1594",
journal = "Clinical Ophthalmology",
issn = "1177-5467",
publisher = "Dove Medical Press Ltd.",

}

TY - JOUR

T1 - Infectious uveitis in virginia

AU - Engelhard, Stephanie B.

AU - Haddad, Zeina

AU - Bajwa, Asima

AU - Patrie, James

AU - Xin, Wenjun

AU - Reddy, Ashvini

PY - 2015/8/28

Y1 - 2015/8/28

N2 - Purpose: To report the causes, clinical features, and outcomes of infectious uveitis in patients managed in a mid-Atlantic tertiary care center. Methods: Retrospective, observational study of infectious uveitis patients seen at the University of Virginia from 1984 to 2014. Results: Seventy-seven of 491 patients (15.7%) were diagnosed with infectious uveitis (mean age 58 years, 71.4% female, 76.6% Caucasian). The mean follow-up was 5 years. Anterior uveitis was the most common anatomic classification (39 patients, 50.6%) followed by panuveitis (20 patients, 26.0%) and posterior uveitis (18 patients, 23.4%). The most common infectious etiology was herpetic anterior uveitis (37 patients, 48.1%) followed by toxoplasma uveitis (14 patients, 18.2%). The most prevalent viral pathogen was varicella-zoster virus (21 patients, 27.3%) followed by herpes simplex virus (20 patients, 26.0%). Acute retinal necrosis (ARN) was diagnosed in 14 patients (18.2%). Aqueous humor yielded an etiologic diagnosis in seven (50%) of ARN patients, four of whom tested positive for cytomegalovirus and three for varicella-zoster virus. On presentation, 43 patients (55.8%) had a visual acuity (VA) better than 20/40 and 17 (22.1%) had a VA worse than 20/200. VA at the final follow-up was better than 20/40 in 39 patients (50.6%) and worse than 20/200 in 22 patients (28.6%). In all, 16 (20.8%) and 10 (13.0%) patients required cataract and vitrectomy surgery, respectively. A total of 14 patients (18.2%) were on glaucoma topical treatment and four (5.2%) required glaucoma surgery. Conclusion: The most common type of infectious uveitis seen over the study period was herpetic anterior uveitis secondary to varicella-zoster virus or herpes simplex virus, found to be most prevalent in patients over 60 years of age. This finding is comparable to other American epidemiologic studies. Ocular toxoplasmosis and ARN were also common causes of infectious uveitis. In all, 50.6% of patients had a VA better than 20/40 at the final follow-up visit, indicating the importance of prompt referral and appropriate treatment.

AB - Purpose: To report the causes, clinical features, and outcomes of infectious uveitis in patients managed in a mid-Atlantic tertiary care center. Methods: Retrospective, observational study of infectious uveitis patients seen at the University of Virginia from 1984 to 2014. Results: Seventy-seven of 491 patients (15.7%) were diagnosed with infectious uveitis (mean age 58 years, 71.4% female, 76.6% Caucasian). The mean follow-up was 5 years. Anterior uveitis was the most common anatomic classification (39 patients, 50.6%) followed by panuveitis (20 patients, 26.0%) and posterior uveitis (18 patients, 23.4%). The most common infectious etiology was herpetic anterior uveitis (37 patients, 48.1%) followed by toxoplasma uveitis (14 patients, 18.2%). The most prevalent viral pathogen was varicella-zoster virus (21 patients, 27.3%) followed by herpes simplex virus (20 patients, 26.0%). Acute retinal necrosis (ARN) was diagnosed in 14 patients (18.2%). Aqueous humor yielded an etiologic diagnosis in seven (50%) of ARN patients, four of whom tested positive for cytomegalovirus and three for varicella-zoster virus. On presentation, 43 patients (55.8%) had a visual acuity (VA) better than 20/40 and 17 (22.1%) had a VA worse than 20/200. VA at the final follow-up was better than 20/40 in 39 patients (50.6%) and worse than 20/200 in 22 patients (28.6%). In all, 16 (20.8%) and 10 (13.0%) patients required cataract and vitrectomy surgery, respectively. A total of 14 patients (18.2%) were on glaucoma topical treatment and four (5.2%) required glaucoma surgery. Conclusion: The most common type of infectious uveitis seen over the study period was herpetic anterior uveitis secondary to varicella-zoster virus or herpes simplex virus, found to be most prevalent in patients over 60 years of age. This finding is comparable to other American epidemiologic studies. Ocular toxoplasmosis and ARN were also common causes of infectious uveitis. In all, 50.6% of patients had a VA better than 20/40 at the final follow-up visit, indicating the importance of prompt referral and appropriate treatment.

KW - Chorioretinitis

KW - Endophthalmitis

KW - Infectious

KW - Toxoplasma

KW - Uveitis

UR - http://www.scopus.com/inward/record.url?scp=84940745892&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84940745892&partnerID=8YFLogxK

U2 - 10.2147/OPTH.S86578

DO - 10.2147/OPTH.S86578

M3 - Article

C2 - 26355608

AN - SCOPUS:84940745892

VL - 9

SP - 1589

EP - 1594

JO - Clinical Ophthalmology

JF - Clinical Ophthalmology

SN - 1177-5467

ER -