Incidence and Prevalence of Uveitis and Associated Ocular Complications in the United States TriNetX Database.

Abstract

Objective: To analyze the demographics, immunosuppressant use, associated systemic diseases, ocular comorbidities, and incidence and prevalence of uveitis and associated low vision using the United States TriNetX database from 2013-2023.

Design: Retrospective cross-sectional and trend study PARTICIPANTS: Subjects with uveitis in the TriNetX database METHODS: Subjects with uveitis were identified with International Classification for Disease codes and then divided into anatomic subtypes based on the diagnosis. Incidence and prevalence data were collected from 2013-2023. Additional data collected included demographics, use of systemic immunosuppressive medications, presence of an associated systemic disease, and associated ocular complications.

Main outcome measures: The primary outcomes were the incidence and prevalence of uveitis (annual and cumulative) with additional analysis by anatomic subtype. Secondary outcomes were the incidence and prevalence of low vision (annual and cumulative).

Results: Out of the 109,026,851 subjects in the database, 278,333 (0.26%) had a diagnosis of uveitis. The mean age was 56 years (Standard Deviation=21, 95% Confidence Interval (CI) 55.9-56.1), and the majority were female (n=149,186; 53.6%, 95% CI 53.4-53.8%) and white (n=150,578; 54.1%, 95% CI 53.9-54.3%). Anterior uveitis was the most common subtype (n=209,073, 75.1%). Oral prednisone (n=62,834; 22.6%, 95% CI 22.5-22.8%) was the most used immunosuppressant and methotrexate (n=15,817; 5.7%, 95% CI 5.6-5.8%) was the most prevalent corticosteroid-sparing immunosuppressive agent. Inflammatory spondyloarthropathies (n=18,372; 6.6%, 95% CI 6.5-6.7%) were the most frequently associated systemic disease. The cumulative incidence and prevalence of uveitis from 2013-2023 were 212.5 and 260.8 per 100,000 persons, respectively.

Conclusions: This study represents one of the largest uveitis populations analyzed in the United States, revealing a rising incidence of all uveitis subtypes and an increase in low vision among affected patients over the past decade in the database. Prospective studies are needed to identify the factors driving these trends and to develop strategies to prevent vision loss and ocular complications in uveitis patients.