The Association of Uveitis with Prior Ocular Surgeries: A Within-Person Matched Case-Control Study

Area of Science:

• Ophthalmology
• Immunology

Background:

• Uveitis is inflammation of the uvea, often of idiopathic origin.
• Identifying risk factors for uveitis is crucial for understanding its etiology, particularly in cases without systemic autoimmune disease.

Purpose of the Study:

• To investigate whether ocular procedures are a significant risk factor for developing uveitis in patients without pre-existing systemic autoimmune conditions.

Main Methods:

• A retrospective, within-person matched case-control study was conducted using US Medicare healthcare claims data (2015-2020).
• Patients with unilateral uveitis were compared to their fellow non-uveitic eyes, excluding those with endophthalmitis or recent autoimmune disease/uveitis history.
• Odds ratios for prior ocular procedures (incisional surgeries, laser procedures, intravitreal injections) were calculated using McNemar's test.

Main Results:

• The study included 565 patients. Uveitic eyes showed significantly higher odds of prior ocular procedures (OR, 1.9).
• Specific procedures like incisional surgeries (OR 2.0), laser procedures (OR 2.4), and intravitreal injections (OR 4.8) were associated with increased uveitis odds.
• Significant associations were found for complex cataract surgery, corneal surgery, glaucoma surgery, and pars plana vitrectomy, but not routine cataract surgery.

Conclusions:

• Prior ocular procedures appear to be a risk factor for developing uveitis in individuals without systemic autoimmune disease.
• These findings contribute to understanding the causes of "idiopathic" uveitis, suggesting a link to prior ocular interventions.