Non-invasive biomarkers for close activity monitoring in birdshot chorioretinitis: Optical coherence tomography angiography and beyond.

PURPOSE: The purpose of the study was to identify non-invasive imaging biomarkers potentially useful for close activity monitoring in birdshot chorioretinitis (BSCR). METHODS: Cross-sectional study of BSCR eyes included as per Levinson's and/or SUN criteria. Eyes were blindly classified into active or inactive groups per clinical inflammatory parameters, ultra-widefield (UWF) pseudocolour images, UWF fluorescein angiography (FA) and macular optical coherence tomography (OCT) cube. Qualitative and quantitative OCT and OCT-angiography (OCT-A) parameters at the fundus, superonasal and inferonasal fields were compared between active and inactive eyes. RESULTS: Thirty consecutive BSCR patients (60 eyes) were analysed. 28 eyes (46.66%) were from women and the overall mean age was 59.7 ± 12.3 years. Active eyes showed an abnormal retinal thickening at inferonasal field (nasal retinal thickness) and a higher averaged thickened retinal index (ATRI) (72.36 active vs. 20.12 inactive, p < 0.0001). A significant moderate correlation was observed between ATRI and FA scores (r = 0.259, p = 0.022). Macular vascular loops were more frequent in the superficial vascular plexus of OCT-A in the active eyes (p = 0.028). The vascular perfusion index tended to be higher in all subfields of active eyes but did not reach statistical significance. CONCLUSION: Multimodal imaging could be key to discerning activity in BSCR eyes. Higher ATRI and the presence of vascular loops in the superficial plexus are potential non-invasive activity biomarkers for the close monitoring of BSCR.

Carga y costes directos de la uveítis no infecciosa en España / Burden and direct costs of non infectious uveitis in Spain

OBJETIVOS: No existen datos actualizados sobre la epidemiología y los costes asociados de la uveítis no infecciosa (UNI) en España. Este estudio investiga la frecuencia de los tipos de uveítis y el coste de los recursos utilizados en su manejo en 2011. Material y método. Se recogió información mediante búsqueda bibliográfica de datos epidemiológicos y de costes directos de la UNI. La información se completó mediante consenso de 2 paneles de expertos y cuestionario a oftalmólogos y reumatólogos especialistas en esta enfermedad. Los costes de los recursos se obtuvieron de la base de datos Oblikue, de una sociedad médica y de los precios de los medicamentos aprobados en España. RESULTADOS: En 2011 se diagnosticaron 9.398 nuevos pacientes de UNI (45% hombres, el 70% entre 16 y 65 años). La incidencia por tipos fue: uveítis anterior aguda (UAA) 55%, uveítis posterior (UP) y panuveítis (PU) 15% y uveítis anterior crónica en edad adulta, uveítis anterior crónica pediátrica y uveítis intermedia 5%. Del total de costes calculados (77.834.282,10 €), el tratamiento farmacológico inicial fue el recurso más costoso (43.602.359,29 €), seguido del tratamiento quirúrgico de las complicaciones (8.367.420,43 €). Respecto a los tipos de uveítis, los costes asociados más elevados fueron los de la PU (26.692.948,29 €), la UP (22.283.330,50 €) y la UAA (14.336.755,38 €). CONCLUSIONES: La UNI en España genera unos elevados costes tanto de diagnóstico como de tratamiento. Un diagnóstico y tratamiento precoz de la enfermedad permitirían un ahorro sustancial al Sistema Nacional de Salud

OBJECTIVES: There is no updated information on epidemiology and cost of management of non infectious uveitis (NIU) in Spain. This study assessed the frequency of various types of uveítis as well as associated costs of resources used in their management. Material and method. NIU epidemiological data and direct costs were collected from a literature search. This was complemented with consensus information from 2 expert panel meetings and data from questionnaires to ophthalmologists and rheumatologists, experts on these conditions. Healthcare resources costs were obtained from the Oblikue database, from a medical society and from approved drug prices in Spain. RESULTS: During 2011 the estimate number of NIU was 9,398 (45% male, 70% aged 16-65 years). Incidence per type of uveitis was: acute anterior uveitis (AAU) 55%; posterior uveitis (PU) and pan-uveitis (PanU) 15% each; adult chronic anterior uveitis, paediatric chronic anterior uveitis and intermediate uveitis 5% each. Among total costs (77,834,282.10€), initial drug therapy was the highest (43,602,359.29€), followed by surgical treatment of complications (8,367,420.43€). With respect to types of uveitis, PanU (26,692,948.29€), PU (22,283,330.50€) and AAU (14,336,755.38€) showed the highest associated costs. CONCLUSIONS: Non infectious uveitis is associated to high costs in Spain, both in its diagnosis and in its treatment. Early diagnosis and treatment should allow for substantial savings for the National Health System

Burden and direct costs of non infectious uveitis in Spain. / Carga y costes directos de la uveítis no infecciosa en España.

OBJECTIVES: There is no updated information on epidemiology and cost of management of non infectious uveitis (NIU) in Spain. This study assessed the frequency of various types of uveítis as well as associated costs of resources used in their management. MATERIAL AND METHOD: NIU epidemiological data and direct costs were collected from a literature search. This was complemented with consensus information from 2 expert panel meetings and data from questionnaires to ophthalmologists and rheumatologists, experts on these conditions. Healthcare resources costs were obtained from the Oblikue database, from a medical society and from approved drug prices in Spain. RESULTS: During 2011 the estimate number of NIU was 9,398 (45% male, 70% aged 16-65 years). Incidence per type of uveitis was: acute anterior uveitis (AAU) 55%; posterior uveitis (PU) and pan-uveitis (PanU) 15% each; adult chronic anterior uveitis, paediatric chronic anterior uveitis and intermediate uveitis 5% each. Among total costs (77,834,282.10€), initial drug therapy was the highest (43,602,359.29€), followed by surgical treatment of complications (8,367,420.43€). With respect to types of uveitis, PanU (26,692,948.29€), PU (22,283,330.50€) and AAU (14,336,755.38€) showed the highest associated costs. CONCLUSIONS: Non infectious uveitis is associated to high costs in Spain, both in its diagnosis and in its treatment. Early diagnosis and treatment should allow for substantial savings for the National Health System.