Uveal coloboma results in a visual acuity (VA) of worse than 20/400 in over one-third of eyes with the disease and primarily affects individuals in economically disadvantaged groups residing in rural areas, according to research published in the American Journal of Ophthalmology

Researchers conducted a cross-sectional, observational study of 2,817,766 patients presenting to a multi-tier ophthalmology network between May 2012 and May 2021. They identified uveal coloboma in 14,371 eyes of 9557 patients through an electronic medical record system. The primary objective was to present clinical and demographic profiles of individuals with uveal coloboma. 

Among patients with uveal coloboma, the mean age at diagnosis was 26.75±17.94 years. Over half of the patients were men (51.82%) and the disease manifested bilaterally in over half of patients (50.37%). Researchers found that study participants with uveal coloboma were primarily members of lower or lower-middle class socioeconomic groups (98.06% combined). This indicates an overall prevalence of 0.53% in patients earning lower incomes (0.53%) compared with those from a higher socio-economic stratum (0.28%) (P =.00001). They also noted a higher prevalence among individuals from rural communities compared with urban and metropolitan environments (0.39%, 0.32%, and 0.22%, respectively, P =.00001).


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A total of 5696 (39.64%) eyes with uveal coloboma experienced a visual impairment of blindness (VA worse than 20/400). Overall, one-tenth of eyes received surgical intervention. The most common surgeries performed were cataract surgery (6.62%) and vitreo-retinal surgery (4.6%).

“The causes of coloboma are multifactorial, and both genetic and environmental factors have been studied,” according to the researchers. The team highlights their observation of high prevalence rates in rural and lower earning socioeconomic populations and states, “although it was not possible to study the exact reasons for this observation, the association with higher prevalence in lower socioeconomic strata needs to be evaluated and studied further.”

Study limitations include the inability to determine potential confounders and the inability to make direct comparisons with population-based prevalence studies from the electronic based medical registry.

Reference

Das AV, Rauniyar D, Chaurasia S, Jalali S, Padhi TR. Clinical and demographic profile of uveal coloboma: a hospital-based study of 14,371 eyes of 9557 Indian patients. Am J Ophthalmol. Published online May 2022. doi:10.1016/j.ajo.2022.05.014