Clinical and etiologic characteristics of de novo uveitis in patients aged 60 years and above: experience of a French tertiary center

Graefes Arch Clin Exp Ophthalmol. 2019 Sep;257(9):1971-1979. doi: 10.1007/s00417-019-04411-1. Epub 2019 Jul 16.

Abstract

Purpose: To describe the characteristics of de novo uveitis in patients ≥ 60 years old.

Methods: Retrospective review of patients with uveitis followed in our tertiary center over a 14-year period. Patients aged 60-70 years and patients aged > 70 years were compared.

Results: A total of 283/1044 (27.1%) patients with uveitis were ≥ 60 years of age. Idiopathic uveitis (36.1%) and sarcoidosis (31.5%) were the most frequent etiologies. Sarcoidosis was significantly more frequent (31.5% vs. 13.7%, p < 0.0001) after the age of 60 years. Intraocular lymphoma (5.0% vs. 1.1%) and herpes virus infection (5.0% vs. 0.9%) were also more common in this age group, unlike HLA B27-related uveitis and spondyloarthritis (4.6% vs. 14.9%). Pure ophthalmologic entities: birdshot retinochoroidopathy (2.8%) or Fuchs uveitis (0.4%), were rare in patients ≥ 60 years of age and Posner Scholssman, Pars planitis, White dots syndrome, Behçet's disease, and Multiple Sclerosis were never reported. In patients > 70 years old, idiopathic uveitis (41.1% vs. 31.7%) and presumed sarcoidosis (56.5% vs. 25.6%) were more frequent than in the 60-70-year age group.

Conclusion: In our center, sarcoidosis is the leading cause of non-idiopathic uveitis in older patients. Idiopathic uveitis and other entities account for less than two-thirds of cases. Ophthalmologic entities are rare after 60 years of age. We also report for the first time the characteristics of uveitis after 70 years of age.

Keywords: Diagnosis; Epidemiology; Etiology; Older patients; Sarcoidosis; Uveitis.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Animals
  • Behcet Syndrome / complications*
  • Eye Neoplasms / complications*
  • Female
  • Fluorescein Angiography / methods
  • France / epidemiology
  • Fundus Oculi
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Ophthalmoscopy / methods
  • Retrospective Studies
  • Sarcoidosis / complications*
  • Tertiary Care Centers / statistics & numerical data*
  • Tomography, Optical Coherence / methods
  • Uveitis / diagnosis*
  • Uveitis / epidemiology
  • Uveitis / etiology