​​Uveitis More Likely Among Black Patients, Women and the Elderly

As might be expected, anterior uveitis (63.8%) represented the majority of cases in this analysis of IRIS data. Photo: Aaron Bronner, OD, and Alison Bozung, OD. Click image to enlarge. While it’s known that uveitis is a debilitating disorder that can cause blindness, what’s less well known is the demographics and healthcare burden of this condition in the United States. In a recent study, researchers aimed to characterize demographics of ocular inflammatory disease (OID) patients within the American Academy of Ophthalmology Intelligent Research in Sight (IRIS) Registry and quantify OID-related healthcare burden relative to other ophthalmic diseases. They observed an increased burden associated with increased age and female sex as well as among Black patients, along with $200 million in healthcare costs in uveitis visits.Uveitis and scleritis cases were identified and divided into anatomic categories by ICD codes for noninfectious uveitis. Anatomic location of inflammation was identified by ICD-9 or ICD-10 as anterior uveitis, intermediate uveitis, posterior uveitis, retinal vasculitis, panuveitis, scleritis or mixed. Mixed OID was defined as scleritis plus any additional location diagnosed within 30 days. Patients with both anterior and intermediate uveitis within 30 days of initial diagnosis were categorized as intermediate uveitis, and all other combinations without scleritis were classified as panuveitis.To measure the healthcare burden, follow-up visits were tallied from January 2017 through December 2020. Relative value units derived from CPT codes were summed and multiplied by the 2017 national Medicare conversion factor (35.8887) to obtain an estimate of healthcare cost.Of 72,169,556 patient visits, 1,970,431 were attributable to ocular inflammatory disease cases. Patients without OID had a mean 5.4 visits compared with 12 for new-onset cases. Despite comprising only 1.6% of total patients, those with OID incurred 2.5% of the total 2017 costs (roughly $200 million),  “representing a disproportionately high burden of healthcare resources within ophthalmology practices,” the authors wrote in their Ophthalmology paper.Of the 527,978 OID cases identified, the breakdown is as follows: 63.8% anterior uveitis, 20.1% scleritis, 6.7% posterior uveitis, 5% panuveitis, 2.3% intermediate uveitis, 1.4% retinal vasculitis and 0.7% mixed cases.OID and non-OID patients were of the same median age (62 years), but OID cases were more likely to be seen among female patients. Black patients had the highest disease burden compared with other races, accounting for 17% of cases.Ocular inflammatory disease appears to increase with advancing age. Beyond age 20, women have a greater burden than men. Overall, the female-to-male relative risk was 1.51 with a maximum at age 60. Scleritis, retinal vasculitis and intermediate uveitis demonstrated the greatest sex-based difference (female-to-male relative risks of 2.01, 1.84 and 1.67, respectively).Click here for the journal source. Hunt MS, McKay M, Lee AY, et al. Burden of noninfectious ocular inflammatory disease in US ophthalmology practice. Ophthalmology. May 19, 2025. [Epub ahead of print.]