Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Epidemiology of Uveitis: Incidence and Prevalence in a Small Urban Community

Epidemiology of Uveitis: Incidence and Prevalence in a Small Urban Community Abstract In this paper the literature concerning the demographic characteristics of uveitis will be reviewed, and a 10-year retrospective survey of the disease among residents of Rochester, Minnesota, will be presented. Descriptive epidemiology attempts to measure the risk of developing a disease in different populations and to characterize the affected individuals with respect to geographic location, age, sex, race, occupation, socioeconomic status, and time of illness. There is, to our knowledge, no data on the prevalence of uveitis in the United States based on a survey of all residents of a community. If the prevalence of uveitis could be measured accurately in several places, it might be possible to identify those population characteristics associated with an unusual prevalence of the disease. Clinical and laboratory research as well as epidemiological analysis could then be concentrated on populations with contrasting risks of developing uveitis, in the hope of identifying causal factors with a References 1. Dr. Wagener died April 27, 1961. 2. Oksala, for example, was not able to assign an etiologic diagnosis to one-half of his 100 cases14; Schlaegel reported good evidence for making a probable etiologic diagnosis in only 17% of his 100 cases15; Smith and Ashton found that in 40%-50% of their 200 cases clinical and laboratory investigations gave no indication whatever of etiology, and in not more than 10% could a certain diagnosis be established." 3. It is assumed that the individuals in a population are repeatedly exposed to the occurrence of an event that strikes the population at random.31 Some of the exposed individuals will develop illness and others not; the responses would vary in the socalled normal curve. Given the same frequency with which exposure takes place, more or fewer cases might be manifest merely because of the distribution of individual response on the "normal curve." How great a difference in the number of cases can be assumed to represent an actual increase in frequency of disease in the population rather than a variation within the limits of normal response? For small numbers of cases (under 50) compared to a relatively large population at risk, this normal variation is measured by the Poisson distribution.32 For larger numbers of cases it is measured by the binomial theory. The 95% confidence limits, which have been calculated for all incidence and prevalence rates, represent the limits within which the true value in the population could be expected to fall 19 out of 20 times. 4. In the United States, Hurlin has analyzed 21,000 records of recipients of aid to the blind; 9.2% of the cases were related to iritis, iridocyclitis, uveitis, choroiditis, or chorioretinitis.22 Comparing 9.2% of all estimated blind to the total population in that year yields a minimal prevalence of 16 per 100,000. In Pennsylvania, the cases of 16% of the registered blind over the age of 21 were related to iritis, iridocyclitis, keratoiritis, plastic iritis, cyclitis, complicated cataract, or to choroiditis.21 Comparing the number of these cases to the population over 21 in the state yields a prevalence of 41 per 100,000 population. Below the age of 19, uveitis is a cause of less than 1% of blindness.19,23,24 Three per cent of 31,000 cases of blindness registered for the first time in England and Wales during 1951-1954 were related to iritis, iridocyclitis, or to choroidal lesions of undetermined etiology.25 The prevalence of blindness related to these categories in the general population would be 6 per 100,000. In Iceland Bjornsson found 15 cases of blindness related to uveitis, a prevalence of 10 per 100,000 population.20 5. Clark, W. B.; Allen, J. H.; Leckert, E. L., Jr.; Lorenzen, R. F., and Wang, Y. L.: A Preliminary Report of an Ophthalmic Survey on a Mass Population in Southern Rural Mississippi , Trans. Amer. Ophthal. Soc. 51:43, 1954. 6. Clark, W. B.; Bancroft, H.; Allen, J. H., and Wang, Y. L.: Incidence of Visual Defects in 2 Rural Counties of Mississippi and a Rural Parish of Louisiana (Paper written at the Department of Ophthalmology, Tulane University). 7. Feldman, H. A., and Mou, T. W.: Some Epidemiological Aspects of Uveitis: Personal communication to the author. 8. Mann, I.: Researches into the Regional Distribution of Eye Disease , Amer. J. Ophthal. 47:134 (May, (Pt. 2) ) 1959. 9. Mann, I.: Ophthalmic Survey of the Kimberley Division of Western Australia , Perth, Government Printing Office, 1954. 10. Mann, I.: Ophthalmic Survey of the Eastern Goldfields Area of Western Australia , Perth, Government Printing Office, 1954. 11. Mann, I.: Ophthalmic Survey of the South West Portion of Western Australia , Perth, Government Printing Office, 1956. 12. Mann, I.: Ophthalmic Survey of the Territories of Papua and New Guinea, 1955 , Port Moresby, Government Printing Office, 1956. 13. Mann, I.: Geographic Ophthalmology: A Study of 2 Isolated Island Cultures , Amer. J. Ophthal. 51:1229, 1961. 14. Bennett, G.: Uveitis: A Clinical and Statistical Survey , Brit. J. Ophthal. 39:727, 1955.Crossref 15. Crawford, H. E.; Hamman, G. C., and Lanwi, I.: Ophthalmological Survey of the Trust Territory of the Pacific Islands, New Caledonia, South Pacific Commission Technical Paper No. 67, 1954. 16. Guyton, J. S., and Woods, A. C.: Etiology of Uveitis: A Clinical Study of 562 Cases , Arch. Ophthal. 26:983, 1941.Crossref 17. Müller, H.: Zur Pathogenese der endogenen, nicht eitrigen Uveitis, insbesondere zur Bedeutung der Infektallergie , Graefe. Arch. Ophthal. 150:423, 1950. 18. Oksala, A.: Ätiologie der Uveitis in Mittel-Finnland , Docum. Ophthal. 14:399, 1960.Crossref 19. Schlaegel, T. F., Jr.: Granulomatous Uveitis: An Etiologic Survey of 100 Cases , Trans. Amer. Acad. Ophthal. Otolaryng. 62:813, 1958. 20. Smith, C., and Ashton, N.: Studies on the Aetiological Problem of Uveitis , Brit. J. Ophthal. 39:545, 1955.Crossref 21. Stanworth, A., and McIntyre, H.: Communications: Aetiology of Uveitis , Brit. J. Ophthal. 41: 385, 1957.Crossref 22. Streiff, E. B., and Cuendet, J. F.: L'influence du rythme des saisons sur la fréquence de certaines affections oculaires , Ann. Oculist. (Par.) 182:329, 1949. 23. Belloc, N. B.; Fowler, D. H., and Simmons, W. D.: Causes of Blindness in California , Sight-Sav. Rev. 27:98, 1957. 24. Bjornsson, G.: Prevalence and Causes of Blindness in Iceland , Amer. J. Ophthal. 39:202, 1955. 25. Cowan, A., and English, B.: Causes of Blindness in Pennsylvania , Arch. Ophthal. 26:797, 1941.Crossref 26. Hurlin, R. G.; Saffian, S., and Rice, C. E.: Causes of Blindness Among Recipients of Aid to the Blind , Washington, United States Government Printing Office, 1947. 27. Kerby, C. E.: Causes of Blindness in Children of School Age , Sight-Sav. Rev. 28:10, 1958. 28. Kerby, C. E.: Blindness in Pre-School Children , Sight-Sav. Rev. 24:15, 1954. 29. Sorsby, A.: Blindness in England, 1951-54: Report to the Ministry of Health (Great Britain) , London, Her Majesty's Stationery Office, 1956. 30. Kurland, L. T., and Taub, R. G.: The Frequency of Glaucoma in a Small Urban Community , Amer. J. Ophthal. 43:539 (April, (Pt. 1) ) 1957. 31. Kurland, L. T.: Descriptive Epidemiology of Selected Neurologic and Myopathic Disorders with Particular Reference to a Survey in Rochester, Minnesota , J. Chron. Dis. 8:378, 1958.Crossref 32. Hogan, M. J.; Kimura, S. J., and Thygeson, P.: Signs and Symptoms of Uveitis , Amer. J. Ophthal. 47:155 (May, (Pt. 2) ) 1959. 33. Kimura, S. J.; Thygeson, P., and Hogan, M. J.: Signs and Symptoms of Uveitis , Amer. J. Ophthal. 47:171 (May, (Pt. 2) ) 1959. 34. Committee on Medical Rating of Physical Impairment: Guides to the Evaluation of Permanent Impairment: The Visual System , J.A.M.A. 168:475, 1958.Crossref 35. Treloar, A. E.: Biometric Analysis , Chapter II: Proportional Frequency and Probability , Minneapolis, Burgess Publishing Co., 1951. 36. Pearson, E. S., and Hartley, H. O.: Biometrika Tables for Statisticians , Vol. 1, Cambridge, University Press, 1956. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Epidemiology of Uveitis: Incidence and Prevalence in a Small Urban Community

Loading next page...
 
/lp/american-medical-association/epidemiology-of-uveitis-incidence-and-prevalence-in-a-small-urban-UeADL95f0U
Publisher
American Medical Association
Copyright
Copyright © 1962 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1962.00960030506014
Publisher site
See Article on Publisher Site

Abstract

Abstract In this paper the literature concerning the demographic characteristics of uveitis will be reviewed, and a 10-year retrospective survey of the disease among residents of Rochester, Minnesota, will be presented. Descriptive epidemiology attempts to measure the risk of developing a disease in different populations and to characterize the affected individuals with respect to geographic location, age, sex, race, occupation, socioeconomic status, and time of illness. There is, to our knowledge, no data on the prevalence of uveitis in the United States based on a survey of all residents of a community. If the prevalence of uveitis could be measured accurately in several places, it might be possible to identify those population characteristics associated with an unusual prevalence of the disease. Clinical and laboratory research as well as epidemiological analysis could then be concentrated on populations with contrasting risks of developing uveitis, in the hope of identifying causal factors with a References 1. Dr. Wagener died April 27, 1961. 2. Oksala, for example, was not able to assign an etiologic diagnosis to one-half of his 100 cases14; Schlaegel reported good evidence for making a probable etiologic diagnosis in only 17% of his 100 cases15; Smith and Ashton found that in 40%-50% of their 200 cases clinical and laboratory investigations gave no indication whatever of etiology, and in not more than 10% could a certain diagnosis be established." 3. It is assumed that the individuals in a population are repeatedly exposed to the occurrence of an event that strikes the population at random.31 Some of the exposed individuals will develop illness and others not; the responses would vary in the socalled normal curve. Given the same frequency with which exposure takes place, more or fewer cases might be manifest merely because of the distribution of individual response on the "normal curve." How great a difference in the number of cases can be assumed to represent an actual increase in frequency of disease in the population rather than a variation within the limits of normal response? For small numbers of cases (under 50) compared to a relatively large population at risk, this normal variation is measured by the Poisson distribution.32 For larger numbers of cases it is measured by the binomial theory. The 95% confidence limits, which have been calculated for all incidence and prevalence rates, represent the limits within which the true value in the population could be expected to fall 19 out of 20 times. 4. In the United States, Hurlin has analyzed 21,000 records of recipients of aid to the blind; 9.2% of the cases were related to iritis, iridocyclitis, uveitis, choroiditis, or chorioretinitis.22 Comparing 9.2% of all estimated blind to the total population in that year yields a minimal prevalence of 16 per 100,000. In Pennsylvania, the cases of 16% of the registered blind over the age of 21 were related to iritis, iridocyclitis, keratoiritis, plastic iritis, cyclitis, complicated cataract, or to choroiditis.21 Comparing the number of these cases to the population over 21 in the state yields a prevalence of 41 per 100,000 population. Below the age of 19, uveitis is a cause of less than 1% of blindness.19,23,24 Three per cent of 31,000 cases of blindness registered for the first time in England and Wales during 1951-1954 were related to iritis, iridocyclitis, or to choroidal lesions of undetermined etiology.25 The prevalence of blindness related to these categories in the general population would be 6 per 100,000. In Iceland Bjornsson found 15 cases of blindness related to uveitis, a prevalence of 10 per 100,000 population.20 5. Clark, W. B.; Allen, J. H.; Leckert, E. L., Jr.; Lorenzen, R. F., and Wang, Y. L.: A Preliminary Report of an Ophthalmic Survey on a Mass Population in Southern Rural Mississippi , Trans. Amer. Ophthal. Soc. 51:43, 1954. 6. Clark, W. B.; Bancroft, H.; Allen, J. H., and Wang, Y. L.: Incidence of Visual Defects in 2 Rural Counties of Mississippi and a Rural Parish of Louisiana (Paper written at the Department of Ophthalmology, Tulane University). 7. Feldman, H. A., and Mou, T. W.: Some Epidemiological Aspects of Uveitis: Personal communication to the author. 8. Mann, I.: Researches into the Regional Distribution of Eye Disease , Amer. J. Ophthal. 47:134 (May, (Pt. 2) ) 1959. 9. Mann, I.: Ophthalmic Survey of the Kimberley Division of Western Australia , Perth, Government Printing Office, 1954. 10. Mann, I.: Ophthalmic Survey of the Eastern Goldfields Area of Western Australia , Perth, Government Printing Office, 1954. 11. Mann, I.: Ophthalmic Survey of the South West Portion of Western Australia , Perth, Government Printing Office, 1956. 12. Mann, I.: Ophthalmic Survey of the Territories of Papua and New Guinea, 1955 , Port Moresby, Government Printing Office, 1956. 13. Mann, I.: Geographic Ophthalmology: A Study of 2 Isolated Island Cultures , Amer. J. Ophthal. 51:1229, 1961. 14. Bennett, G.: Uveitis: A Clinical and Statistical Survey , Brit. J. Ophthal. 39:727, 1955.Crossref 15. Crawford, H. E.; Hamman, G. C., and Lanwi, I.: Ophthalmological Survey of the Trust Territory of the Pacific Islands, New Caledonia, South Pacific Commission Technical Paper No. 67, 1954. 16. Guyton, J. S., and Woods, A. C.: Etiology of Uveitis: A Clinical Study of 562 Cases , Arch. Ophthal. 26:983, 1941.Crossref 17. Müller, H.: Zur Pathogenese der endogenen, nicht eitrigen Uveitis, insbesondere zur Bedeutung der Infektallergie , Graefe. Arch. Ophthal. 150:423, 1950. 18. Oksala, A.: Ätiologie der Uveitis in Mittel-Finnland , Docum. Ophthal. 14:399, 1960.Crossref 19. Schlaegel, T. F., Jr.: Granulomatous Uveitis: An Etiologic Survey of 100 Cases , Trans. Amer. Acad. Ophthal. Otolaryng. 62:813, 1958. 20. Smith, C., and Ashton, N.: Studies on the Aetiological Problem of Uveitis , Brit. J. Ophthal. 39:545, 1955.Crossref 21. Stanworth, A., and McIntyre, H.: Communications: Aetiology of Uveitis , Brit. J. Ophthal. 41: 385, 1957.Crossref 22. Streiff, E. B., and Cuendet, J. F.: L'influence du rythme des saisons sur la fréquence de certaines affections oculaires , Ann. Oculist. (Par.) 182:329, 1949. 23. Belloc, N. B.; Fowler, D. H., and Simmons, W. D.: Causes of Blindness in California , Sight-Sav. Rev. 27:98, 1957. 24. Bjornsson, G.: Prevalence and Causes of Blindness in Iceland , Amer. J. Ophthal. 39:202, 1955. 25. Cowan, A., and English, B.: Causes of Blindness in Pennsylvania , Arch. Ophthal. 26:797, 1941.Crossref 26. Hurlin, R. G.; Saffian, S., and Rice, C. E.: Causes of Blindness Among Recipients of Aid to the Blind , Washington, United States Government Printing Office, 1947. 27. Kerby, C. E.: Causes of Blindness in Children of School Age , Sight-Sav. Rev. 28:10, 1958. 28. Kerby, C. E.: Blindness in Pre-School Children , Sight-Sav. Rev. 24:15, 1954. 29. Sorsby, A.: Blindness in England, 1951-54: Report to the Ministry of Health (Great Britain) , London, Her Majesty's Stationery Office, 1956. 30. Kurland, L. T., and Taub, R. G.: The Frequency of Glaucoma in a Small Urban Community , Amer. J. Ophthal. 43:539 (April, (Pt. 1) ) 1957. 31. Kurland, L. T.: Descriptive Epidemiology of Selected Neurologic and Myopathic Disorders with Particular Reference to a Survey in Rochester, Minnesota , J. Chron. Dis. 8:378, 1958.Crossref 32. Hogan, M. J.; Kimura, S. J., and Thygeson, P.: Signs and Symptoms of Uveitis , Amer. J. Ophthal. 47:155 (May, (Pt. 2) ) 1959. 33. Kimura, S. J.; Thygeson, P., and Hogan, M. J.: Signs and Symptoms of Uveitis , Amer. J. Ophthal. 47:171 (May, (Pt. 2) ) 1959. 34. Committee on Medical Rating of Physical Impairment: Guides to the Evaluation of Permanent Impairment: The Visual System , J.A.M.A. 168:475, 1958.Crossref 35. Treloar, A. E.: Biometric Analysis , Chapter II: Proportional Frequency and Probability , Minneapolis, Burgess Publishing Co., 1951. 36. Pearson, E. S., and Hartley, H. O.: Biometrika Tables for Statisticians , Vol. 1, Cambridge, University Press, 1956.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Oct 1, 1962

References