Epidemiology and Clinical Features of Uveitis in Southwestern Japan: Laterality and Long-Term Visual Prognosis Based on the Anatomical and Epidemiological Classification.

Purpose: To investigate the epidemiology, clinical features, laterality, and long-term visual prognosis of uveitis.

Methods: This is a retrospective observational study.

Results: We included 1362 patients diagnosed with uveitis at Miyata Eye Hospital, Japan, from 2015 to 2020. The main outcome measures were anatomical and etiological diagnoses, laterality, best-corrected visual acuity (BCVA) at onset and 1, 3, 5, and 10 years thereafter, and ocular complications.Human T-cell leukemia virus type 1 (HTLV-1) uveitis was the most common etiology (10.5%), followed by sarcoidosis (10.4%) and Vogt-Koyanagi-Harada disease (8.7%). Anatomically, panuveitis was most frequent (47.1%), followed by anterior uveitis (42.1%). Anterior uveitis was predominantly unilateral (75.1%), while panuveitis was mostly bilateral (76.9%). Infectious uveitis was largely unilateral (71.0%), whereas non-infectious uveitis was primarily bilateral (76.8%). BCVA at onset was worse in posterior uveitis and panuveitis than in anterior and intermediate uveitis. Posterior uveitis and panuveitis showed significant BCVA improvement at 1 year, while anterior and intermediate uveitis improved at 3 years. Among major etiologies, Behçet's disease had the worst visual prognosis at 10 years. Glaucoma that required treatment was observed in 33.5% of the eyes, with higher prevalence in anterior uveitis (32.5%) and panuveitis (37.9%). Cataract surgery was performed in 38.4% of the eyes during the study period.

Conclusions: This study revealed unique epidemiology in an HTLV-1 endemic area. The laterality patterns and visual prognosis varied by anatomical and etiological diagnoses. Long-term visual outcomes were influenced by anatomical location, etiology, and ocular complications, emphasizing the importance of tailored management strategies for different uveitis types.