The Impact of Delayed Uveitis Diagnosis and Treatment: High Complication Rates at First Specialist Consultation.

Abstract

Purpose: To evaluate the prevalence of complications at the first uveitis specialist visit in patients at a tertiary referral center in Colombia and to identify risk factors associated with multiple complications.

Methods: This cross-sectional study analyzed data from 374 patients (545 eyes) seen for the first time by a uveitis specialist between 2017 and 2022. Demographic and clinical variables, including uveitis type, duration, etiology, and complications, were collected at the initial consultation. Complications included cataracts or cataract surgery, glaucoma, macular edema, posterior synechiae, and severe vision loss. Logistic regression assessed associations between patient characteristics and the presence of three or more complications.

Results: At the first visit, 66.6% of patients presented with at least one complication, and 17.6% had three or more complications. The most common complications were cataracts or cataract surgery (31.7%), severe vision loss (25.9%), posterior synechiae (23.5%), glaucoma/ocular hypertension (21.2%), and macular edema (10.6%). Risk factors for three or more complications included chronic uveitis (odds ratio [OR]: 14.19), delays of over 100 weeks from symptom onset to consultation (OR: 7.67), noninfectious uveitis (OR: 3.32), bilateral inflammation (OR: 2.25), active inflammation (OR: 2.31), and a history of cataract surgery (OR: 6.25).

Conclusion: The high prevalence of complications on the first specialist visit highlights the need for early referral and timely management of uveitis. Delays in care, compounded by limited specialist access, likely contribute to these outcomes.