Uveitis Onset and Flare-Up: Does the Time of Year Matter?

Purpose: This retrospective chart review tests the hypothesis that initial presentation and flare-up of non-infectious anterior, intermediate, and posterior uveitis varies by month, temperature season, and calendar season among the patient population in Connecticut.

Methods: The medical records of all adult patients presenting with a chief concern or diagnosis of "uveitis" at a university-based clinic between March 2013 and February 2019 and a community-based clinic between January 2016 and February 2019 in Connecticut were reviewed. Ongoing, chronic uveitis and infectious/traumatic uveitis were excluded. Patient age, sex, comorbid autoimmune conditions, time of onset, and anatomical location of uveitis was collected. ${\chi }^2$ testing evaluated variation in uveitis presentation based on month, calendar season, and temperature.

Results: 353 cases of endogenous uveitis were identified among 272 patients. There was no significant variation by month, calendar season, or temperature across the entire population. There was no significant variation by temperature when assessing anterior uveitis, intermediate uveitis, posterior uveitis, and panuveitis cases separately. Though flare-ups did not show any significant seasonal trends, there was significant variation by temperature for new uveitis episodes. Uveitis episodes in patients with autoimmune conditions were shown to have significant variation by temperature. Uveitis episodes in HLA-B27 positive patients were found to have significant variation by both temperature and month.

Conclusion: While variation by month, calendar season, or temperature is not present for all uveitis patients, a subset of patients with comorbid autoimmune conditions, specifically HLA-B27 positive, experience temperature variations with increasing incidence of flare-ups in transitional months in Connecticut.