Trends in Patterns of Anterior Uveitis in a Tertiary Institution in Singapore

Tan, Wai Jia; Poh, Eugenie Wei Ting; Wong, Elizabeth; Ho, Samuel Yew Ming; Lim, Wee-Kiak; Teoh, Stephen C.

doi:10.3109/09273948.2013.779725

Cited by 21 publications

(10 citation statements)

References 17 publications

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“…In our population, IU was most common in the Chinese population (57.6%), followed by Asian Indians (18.2%), and Malays (16.7%), which was statistically dissimilar (p<0.001) to our ethnic distribution in Singapore (Chinese 74.1%, Malays 13.4%, Asian Indians 9.2%) [21], suggesting a probable predisposition of the Singapore local Indian population for IU. This is contrasted with our previous findings in AU, which was commonest in the Chinese population (69.8%), followed by Malays (13.2%), and Asian Indians (11.4%) [11]. Our center had a slightly higher prevalence amongst females (54.5%), similar to other published studies (USA 64.0%, Japan 55.0%, India 54.9%) [6]–[7], [22].…”

Section: Discussioncontrasting

confidence: 72%

“…We had previously described the clinical characteristics and changing trends in patterns of etiologies among anterior uveitis (AU) patients seen by the uveitis service of a tertiary eye care center in Singapore [11]. Currently, we aim to report the pattern of etiology trends and clinical characteristics in patients with IU seen similarly by the uveitis service at our center over an 8-year period.…”

Section: Introductionmentioning

confidence: 99%

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Trends in Patterns of Intermediate Uveitis in a Tertiary Institution in Singapore

Lim

et al. 2014

PLoS ONE

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PurposeThe study aims to describe the characteristics and etiologic causes of intermediate uveitis (IU) patients seen by a tertiary eye center in Singapore over 8 years.MethodsThis was a retrospective analysis of the clinical records of consecutive new cases of IU that presented to the uveitis subspecialty clinic from 2004–2011 at Tan Tock Seng Hospital. Data collected included demographics, clinical and laboratory findings. Diagnoses were based on standardized clinical history, ophthalmological examination and investigations.ResultsThere were 66 new cases of IU, comprising 5.7% of 1168 new uveitis patients. The median age of diagnosis was 40 years (mean 39.4±15.9), with largest subgroup of the patients in the age group of 41–60 years (36.4%). The majority was Chinese (57.6%), followed by Asian Indians (18.2%) and Malays (16.7%). The ethnicity distribution was dissimilar to our ethnic distribution in Singapore (p<0.001) with an increased incidence of IU in the Asian Indian population. Most were idiopathic (59.1%) in etiology, followed by tuberculosis (TB) (15.2%). Ocular complications developed in 21 patients (31.8%), with cystoid macular edema (CME) being the commonest (28.8%). Severe vitritis occurred in 9.1% of patients, and was significantly associated with TB-associated IU (p<0.001). There was a downward trend for the incidence of the proportion of IU patients over the total uveitis patients (p = 0.021), with Spearman’s rho of −0.786.ConclusionsDespite the downward trend, TB-associated IU was still of higher prevalence compared to less endemic areas, emphasizing the need for increased TB surveillance. A high index of suspicion for TB-associated IU is required in patients with severe vitritis. Comparisons with other countries revealed disparities in the IU etiologies, indicating possible geographical differences. Prevalence of known immune-mediated etiologies of IU is less compared to the western population. Our study also suggests a probable predisposition of the Singapore local Indian population for IU.

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Section: Discussioncontrasting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Trends in Patterns of Intermediate Uveitis in a Tertiary Institution in Singapore

Lim

et al. 2014

PLoS ONE

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“…Molecular diagnostic techniques have revealed VZV reactivation to be a predominant cause of anterior uveitis in South and East Asian countries [387–389], with significantly increased risk within 1 year following HZ, especially HZO [390]. VZV is also a major cause of acute retinal necrosis [391–397] in the region, and of progressive outer retinal necrosis, which is usually seen in severely immunocompromised patients [398–402].…”

Section: Complicating Presentations and Disease Associationsmentioning

confidence: 99%

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

et al. 2017

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BackgroundHerpes zoster (HZ) is a prevalent viral disease that inflicts substantial morbidity and associated healthcare and socioeconomic burdens. Current treatments are not fully effective, especially among the most vulnerable patients. Although widely recommended, vaccination against HZ is not routine; barriers in Asia-Pacific include long-standing neglect of adult immunisation and sparse local data. To address knowledge gaps, raise awareness, and disseminate best practice, we reviewed recent data and guidelines on HZ from the Asia-Pacific region.MethodsWe searched PubMed, Scopus, and World Health Organization databases for articles about HZ published from 1994 to 2014 by authors from Australia, China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, New Zealand, the Philippines, Singapore, Taiwan, Thailand, and Vietnam. We selected articles about epidemiology, burden, complications, comorbidities, management, prevention, and recommendations/guidelines. Internet searches retrieved additional HZ immunisation guidelines.ResultsFrom 4007 retrieved articles, we screened-out 1501 duplicates and excluded 1264 extraneous articles, leaving 1242 unique articles. We found guidelines on adult immunisation from Australia, India, Indonesia, Malaysia, New Zealand, the Philippines, South Korea, and Thailand.HZ epidemiology in Asia-Pacific is similar to elsewhere; incidence rises with age and peaks at around 70 years – lifetime risk is approximately one-third. Average incidence of 3–10/1000 person-years is rising at around 5% per year. The principal risk factors are immunosenescence and immunosuppression. HZ almost always causes pain, and post-herpetic neuralgia is its most common complication. Half or more of hospitalised HZ patients have post-herpetic neuralgia, secondary infections, or inflammatory sequelae that are occasionally fatal. These disease burdens severely diminish patients’ quality of life and incur heavy healthcare utilisation.ConclusionsSeveral countries have abundant data on HZ, but others, especially in South-East Asia, very few. However, Asia-Pacific countries generally lack data on HZ vaccine safety, efficacy and cost-effectiveness. Physicians treating HZ and its complications in Asia-Pacific face familiar challenges but, with a vast aged population, Asia bears a unique and growing burden of disease. Given the strong rationale for prevention, most adult immunisation guidelines include HZ vaccine, yet it remains underused. We urge all stakeholders to give higher priority to adult immunisation in general and HZ in particular.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2198-y) contains supplementary material, which is available to authorized users.

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“…3 Having said this, the most important step in the management of complicated cataracts is adequate preoperative control of inflammation; most authors consider the absence of cells in the anterior chamber (AC) to be synonymous with inflammatory control, as mild cellular reaction in the vitreous may persist even in inactive stages of FHI. 4 The clinical course, management, and visual outcomes in patients with uveitis may vary according to the type and course of uveitis, along with the technique of cataract surgery. In FHI, conventional extracapsular cataract extraction (ECCE) is associated with complications like bleeding from fragile vessels, posterior capsular rent with vitreous loss, secondary glaucoma, and retinal detachment.…”

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confidence: 99%

Phacoemulsification Versus Manual Small Incision Cataract Surgery in Patients With Fuchs Heterochromic Iridocyclitis

Bhargava

Kumar²,

Sharma³

et al. 2016

Asia-Pacific Journal of Ophthalmology

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Trends in Patterns of Anterior Uveitis in a Tertiary Institution in Singapore

Cited by 21 publications

References 17 publications

Trends in Patterns of Intermediate Uveitis in a Tertiary Institution in Singapore

Trends in Patterns of Intermediate Uveitis in a Tertiary Institution in Singapore

Looking back to move forward: a twenty-year audit of herpes zoster in Asia-Pacific

Phacoemulsification Versus Manual Small Incision Cataract Surgery in Patients With Fuchs Heterochromic Iridocyclitis

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