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Clinical and sociodemographic characteristics of limited and persistent uveitis cases: a population-based study
Abstract
Objective
To compare the clinical and sociodemographic characteristics of limited and persistent uveitis cases and temporal trends in incidence in Ontario.
Methods
A retrospective population-based study using Ontario health administrative data identifying individuals with limited or persistent uveitis. The analysis described demographics, comorbidities, aggregated diagnosis groups (ADGs), resource utilization, income quintiles, and systemic therapy use. Annual age/sex-standardized, and age-specific incidence rates of limited and persistent uveitis were determined.
Results
Between 2000 and 2023, 289 031 limited and 41 482 persistent uveitis cases were identified, with mean index ages of 56.8 (SD 21.0) and 58.3 (SD 20.3) years, respectively. A higher proportion of children and youth were identified with limited duration uveitis. Sex distribution was similar between groups, and 89%–91% of cases resided in urban areas. Persistent uveitis cases had significantly more moderate to high ADGs (86.0%) compared with limited cases (16.2%), with hypertension being the most prevalent comorbidity in both limited (43.8%) and persistent (46.4%) uveitis cases. Persistent cases also had substantially higher resource utilization than limited uveitis cases. Incidence rates were higher for limited uveitis overall and among older age groups. Annual age-specific incidence declined in older age groups but increased over time for children with limited duration uveitis.
Conclusions
This study highlights significant age-related trends in uveitis incidence, including an increase in pediatric cases and a high incidence of uveitis among the elderly. Age-specific health care strategies and resource planning are essential for adapting interventions and ensuring timely access to care.
Uveitis, a complex and multifaceted ocular disorder characterized by intraocular inflammation, presents a challenge in clinical practice and public health management. Its diverse etiology, variable clinical manifestations, and potential sight-threatening consequences underscore the critical importance of a nuanced understanding of its epidemiological patterns. According to the standardized uveitis nomenclature criteria for reporting clinical data, the duration of uveitis is categorized as either limited (3 months or less in duration) or persistent (greater than 3 months in duration).1 The heterogeneity of uveitis cases may have an impact on the diagnosis and ultimately the case definition performance for specific subtypes—in particular, acute cases who have fewer uveitis clinical encounters. Case definitions that compile all cases or exclude those with limited uveitis duration may not provide a comprehensive overview of the burden of uveitis and its heterogeneous disease characteristics. The delineation between limited and persistent uveitis represents a fundamental stratification that would have implications for disease management, resource allocation, and health care planning. Previous systematic reviews on validation studies have highlighted the need for identifying specific disease subtypes within health administrative data.2 Additionally, research has highlighted the heterogeneity across age groups, severity, and clinical subtypes among uveitis cases.3
Phenotyping of observational health data involves defining cohorts within health administrative data and/or large databases to enhance our understanding of that condition.4 The identified phenotypes may play a crucial role in addressing epidemiological questions, such as tracking disease incidence over time, estimating risks, and conducting comparative effectiveness studies.4 Research utilizing well-defined phenotypes can significantly influence policymaking on medical treatments, ultimately impacting population health.5 This study aims to distinguish the characteristics and burden of limited uveitis from that of persistent uveitis using case definitions applied to health administrative data and to examine the attributes and demographics of incident uveitis cases across various age groups in Ontario, Canada.
uveitis
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