Reeves Sherman W, Sloan Frank A, Lee Paul P, Jaffe Glenn J
Duke University Eye Center, Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina 27710, USA.
Ophthalmology. 2006 Feb;113(2):307.e1. doi: 10.1016/j.ophtha.2005.10.008. Epub 2006 Jan 10.
There is a paucity of population-based data on the epidemiology of uveitis in the elderly. In the past 40 years, only 2 U.S. population-based studies have examined the epidemiology of uveitis. The conclusions of these studies on the burden of uveitis in the elderly differ greatly. In this analysis, we use Medicare claims data to define the population-based incidence and prevalence of uveitis in the United States elderly population.
Cohort study.
A cohort of 21644 Medicare beneficiaries drawn for the National Long-term Care Survey, a random sample of U.S. adults 65 years and older, was followed up from 1991 through 1999.
The International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes specific to uveitis were queried. To decrease the inclusion of uveitis caused by surgery, diagnoses occurring within 3 months of intraocular surgery were excluded. The incidence and prevalence of uveitis by anatomic location was calculated for each year in the study.
The onset of uveitis during a given year and its presence in subsequent years.
The cumulative yearly incidence of uveitis ranged from 302/100000 to 424/100000 persons per year and averaged 340.9/100000 persons per year. Anterior uveitis was the most common form of uveitis in this population, with a mean incidence of 243.6 cases per 100000 persons per year. The incidence of posterior uveitis averaged 76.6/100000 and the incidence of panuveitis/endophthalmitis averaged 41.7/100000. Only 2 cases of intermediate uveitis occurred during the study period. The cumulative prevalence of uveitis doubled from 511/100000 in 1991 to 1231/100000 in 1999, with anterior uveitis accounting for most prevalent cases in every year.
The burden of uveitis in the elderly is substantial and is higher than previously thought. Longitudinal analysis of Medicare claims data may provide a useful tool for monitoring uncommon diseases, such as uveitis, in the elderly population.
关于老年葡萄膜炎流行病学的基于人群的数据匮乏。在过去40年里，仅有2项美国基于人群的研究对葡萄膜炎的流行病学进行了考察。这些研究关于老年人群中葡萄膜炎负担的结论差异很大。在本分析中，我们使用医疗保险理赔数据来确定美国老年人群中基于人群的葡萄膜炎发病率和患病率。
队列研究。
从全国长期护理调查中抽取的21644名医疗保险受益人的队列，这是美国65岁及以上成年人的随机样本，从1991年至1999年进行随访。
查询国际疾病分类第九版临床修订版中特定于葡萄膜炎的诊断编码。为减少手术引起的葡萄膜炎的纳入，排除眼内手术后3个月内出现的诊断。计算研究中每年按解剖部位划分的葡萄膜炎发病率和患病率。
特定年份葡萄膜炎的发病情况及其在随后年份的存在情况。
葡萄膜炎的累积年发病率为每年每10万人302/100000至424/100000人，平均每年每10万人340.9/100000人。前葡萄膜炎是该人群中最常见的葡萄膜炎形式，每年每10万人的平均发病率为243.6例。后葡萄膜炎的发病率平均为76.6/100000，全葡萄膜炎/眼内炎的发病率平均为41.7/100000。在研究期间仅发生2例中间葡萄膜炎病例。葡萄膜炎的累积患病率从1991年的511/100000翻倍至1999年的1231/100000，每年前葡萄膜炎占大多数患病病例。
老年人群中葡萄膜炎的负担很重，且高于先前的认识。对医疗保险理赔数据的纵向分析可能为监测老年人群中诸如葡萄膜炎等罕见疾病提供有用工具。
