School of Biological Sciences, The University of Manchester, UK.
Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
Ocul Immunol Inflamm. 2023 Jul;31(5):921-926. doi: 10.1080/09273948.2022.2067067. Epub 2022 Apr 20.
To demonstrate changes in the demography and diagnosis of uveitis in a specialist clinic in the United Kingdom.
Retrieval of data including all new referrals to Manchester Uveitis Clinic from 1991 to 2020. The incidence and proportions of diagnoses between 4 quartiles was compared.
5000 patients with uveitis were seen. Referral rates trebled over time. Highly significant increases in referrals were seen for multiple evanescent white dot syndrome-spectrum disorders, syphilis and tuberculosis; increases were also seen for herpetic retinitis, vitreoretinal lymphoma and sarcoidosis. Highly significant decreases were seen for Fuchs' uveitis, Behçet's uveitis and ocular toxoplasmosis.
Subspecialisation and de-skilling has changed referral patterns to specialist clinics; changes cannot be entirely attributed to disease incidences, which also vary between countries. International data are non-comparable. There are clear changes in referral patterns and disease incidence in this population, influenced by evolving diagnosis. Local data should steer care planning.
展示英国一家专业诊所中葡萄膜炎患者的人口统计学和诊断变化。
检索包括 1991 年至 2020 年期间所有新转诊至曼彻斯特葡萄膜炎诊所的资料。比较了 4 个四分位数之间的诊断发病率和比例。
共观察了 5000 例葡萄膜炎患者。转诊率随时间呈三倍增长。多发性一过性白点综合征谱疾病、梅毒和结核病的转诊率显著增加;疱疹性视网膜炎、眼内淋巴瘤和结节病的转诊率也有所增加。Fuchs 葡萄膜炎、Behçet 葡萄膜炎和眼弓形体病的转诊率显著下降。
亚专科化和技能下降改变了向专科诊所的转诊模式;这些变化不能完全归因于疾病发病率,而疾病发病率在不同国家之间也有所不同。国际数据不具有可比性。在这一人群中,由于诊断方法的不断发展,转诊模式和疾病发病率均发生了明显变化。当地数据应指导护理计划。