Ocular Autoimmune Systemic Inflammatory Infectious Study (OASIS) - Report 2: Pattern of Uveitis Investigations in...

Area of Science:

• Ophthalmology
• Immunology
• Laboratory Medicine

Background:

• Uveitis diagnosis requires extensive laboratory testing.
• Understanding investigation patterns is crucial for resource optimization in tertiary eye care.

Purpose of the Study:

• To analyze the patterns of laboratory investigations for uveitis patients.
• To identify frequently used tests for infective and autoimmune etiologies.
• To assess the yield of utilized tests in a Singaporean tertiary referral center.

Main Methods:

• Retrospective analysis of 2040 uveitis cases from the OASIS database (2004-2015).
• Categorization of uveitis by type: retinal vasculitis, intermediate uveitis, panuveitis, posterior uveitis, anterior uveitis, and keratouveitis.
• Analysis of utilized laboratory tests, including infective and autoimmune markers.

Main Results:

• Patients with retinal vasculitis (RV) had the highest test utilization (6.79 tests/patient).
• Most frequent infective tests: VDRL (41.3%), Syphilis IgG (29.5%), T-SPOT.TB (24.6%).
• Most frequent autoimmune tests: ANA (18.2%), anti-dsDNA (14.8%), HLA-B27 (12.4%).

Conclusions:

• High utilization of autoimmune tests (ANA, anti-dsDNA, RF, ANCA) was observed, often with limited diagnostic yield.
• A rationalized, stepladder approach to investigations may improve the efficiency of resource allocation for ocular inflammation.
• Further studies could refine diagnostic algorithms for uveitis.