Halgurd Bawan, Oest Viktor Skalkhøj, Klefter Oliver Niels, Subhi Yousif, Cicinelli Maria Vittoria, Wied Jimmi, Heegaard Steffen, Neri Piergiorgio, Vorum Henrik, Ørskov Marie, Cehofski Lasse Jørgensen
Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark.
Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark.
Acta Ophthalmol. 2025 Sep;103(6):684-690. doi: 10.1111/aos.17497. Epub 2025 Apr 1.
Uveitis-associated macular edema (UME) is a significant cause of visual impairment in non-infectious uveitis (NIU). However, the UME incidence remains unclear. Here, we evaluated the cumulative incidence of UME.
Medical records of patients registered with a uveitis diagnosis code between 2010 and2024 were assessed to validate uveitis diagnoses of the patient registry of the North Denmark Region, a region of 600 000 inhabitants. Positive predictive values (PPV) were calculated for uveitis diagnosis and subtypes. The data from medical records were used to estimate prevalence, incidence and cumulative incidence of UME. The group differences were analysed by chi-squared test and cox proportional-hazards model.
A total of 1476 medical records were reviewed. The PPV for a uveitis diagnosis was 92.2% (95% CI: 90.7-93.5) and 88.4% (95% Cl: 86.8-90.0) for uveitis subtypes. Among 1218 patients with NIU, 6.9% had UME at referral. During follow-up, 8.3% of the NIU patients developed UME with an incidence rate of 1.4 per 100 person-years (95% CI: 1.3-1.7) and a cumulative incidence of 10.7% (95% CI: 8.5-13.5). A higher incidence of UME was observed for patients with bilateral uveitis, systemic disease, intermediate uveitis, posterior uveitis and panuveitis (p < 0.001). A substantial increase in the cumulative incidence of UME was observed in the first 2 years post-referral.
The high PPV supported the registry's reliability for uveitis research. UME was frequently present at the first uveitis clinic visit. NIU patients were at heightened risk of UME within the first 2 years after referral, indicating an early time window with a critical need for inflammation management.
葡萄膜炎相关黄斑水肿（UME）是非感染性葡萄膜炎（NIU）导致视力损害的重要原因。然而，UME的发病率仍不明确。在此，我们评估了UME的累积发病率。
对2010年至2024年期间登记有葡萄膜炎诊断代码的患者的病历进行评估，以验证北丹麦地区患者登记处的葡萄膜炎诊断，该地区有60万居民。计算葡萄膜炎诊断及亚型的阳性预测值（PPV）。病历数据用于估计UME的患病率、发病率和累积发病率。通过卡方检验和cox比例风险模型分析组间差异。
共审查了1476份病历。葡萄膜炎诊断的PPV为92.2%（95%CI：90.7 - 93.5），葡萄膜炎亚型的PPV为88.4%（95%CI：86.8 - 90.0）。在1218例NIU患者中，6.9%在转诊时患有UME。在随访期间，8.3%的NIU患者发生了UME，发病率为每100人年1.4例（95%CI：1.3 - 1.7），累积发病率为10.7%（95%CI：8.5 - 13.5）。双侧葡萄膜炎、全身性疾病、中间葡萄膜炎、后葡萄膜炎和全葡萄膜炎患者的UME发病率较高（p < 0.001）。在转诊后的前2年观察到UME累积发病率大幅增加。
高PPV支持了该登记处对葡萄膜炎研究的可靠性。UME在首次葡萄膜炎门诊就诊时很常见。NIU患者在转诊后的前2年内发生UME的风险增加，表明存在一个急需进行炎症管理的早期时间窗。
