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  • 1.
    Mollazadegan, Kaziwe
    et al.
    Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Kugelberg, Maria
    St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden.
    Tallstedt, Leif
    St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden.
    Ludvigsson, Jonas F.
    Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.
    Increased risk of uveitis in coeliac disease: a nationwide cohort study2012In: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 96, no 6, p. 857-861Article in journal (Refereed)
    Abstract [en]

    Background: Case reports suggest a potential association between coeliac disease (CD) and uveitis, but larger well-controlled studies are lacking. The aim of this study was therefore to examine the risk of uveitis in patients with biopsy-verified CD.

    Methods: Small intestinal biopsy reports performed between July 1969 and February 2008 were collected from all (n-28) pathology departments in Sweden. From these reports, 29 044 patients with CD (equals villous atrophy, Marsh 3) were identified. Uveitis was defined according to relevant International Classification of Disease codes in the Swedish National Patient Register. Cox regression was used to estimate HR for uveitis in individuals with CD compared with those in reference individuals matched for age, sex, county and calendar year.

    Results: During follow-up, 148 patients with CD developed uveitis (expected count 112), corresponding to a HR of 1.32 (95% CI 1.10 to 1.58). The absolute risk of uveitis was 50/100 000 person-years in CD. The risk estimate did not change more than marginally when adjusted for type 1 diabetes, rheumatoid arthritis and autoimmune thyroid disease (HR 1.30; 95% CI 1.08 to 1.56). The risk of uveitis remained significantly increased even 5 years after CD diagnosis (HR 1.31; 95% CI 1.04 to 1.64).

    Conclusion: A moderately increased risk of uveitis was found in patients with biopsy- verified CD. CD might be considered in patients with uveitis of unknown aetiology.

  • 2.
    Slidsborg, Carina
    et al.
    Department of Ophthalmology, Copenhagen University Hospital, Glostrup Hospital, Glostrup, Denmark.
    Lyng Forman, Julie
    Departmant of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
    Fielder, Alistair R.
    Department of Optometry and Visual Science, City University, London, UK .
    Crafoord, Sven
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Ophthalmology, Örebro University Hospital, Örebro, Sweden.
    Baggesen, Kirsten
    Department of Ophthalmology, Aalborg University Hospital, Aalborg, Denmark .
    Bangsgaard, Regitze
    Department of Ophthalmology, Copenhagen University Hospital, Glostrup Hospital, Glostrup, Denmark.
    Callo Fledelius, Hans
    Department of Ophthalmology, Copenhagen University Hospital, Glostrup Hospital, Glostrup, Denmark.
    Greisen, Gorm
    Department of Neonatology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
    La Cour, Morten
    Department of Ophthalmology, Copenhagen University Hospital, Glostrup Hospital, Glostrup, Denmark.
    Experts do not agree when to treat retinopathy of prematurity based on plus disease2012In: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 96, no 4, p. 549-553Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate inter-reader agreement on five severity levels of central vascular changes (none, mild, moderate, severe pre-plus disease, plus disease) and aggressive posterior retinopathy of prematurity (ROP), and to see whether an unintended shift in indication for treatment occurred.

    Methods: Four international ROP readers participated. Before the grading of the photographs, the readers were informed that a high proportion of advanced ROP cases were included. In total, 243 photographs/948 quadrants were available from 136 infants. As a standard series of photographs was available, grading was performed under optimised conditions.

    Results: The four readers agreed on the quadrant scores of only 70 (7.38%) of the 948 quadrants-that is, on 1, 5, 15, 4 and 45 quadrants for scores 0, 1, 2, 3 and 4, respectively. The mean scores differed systematically between the readers (permutation test, p<0.0001). Agreement on presence of aggressive posterior ROP from all four readers was not obtained for any of the photographs. Readers scored plus disease in at least two quadrants in 95.5% of the eyes for which treatment was indicated. All four readers agreed on the scoring of indication for treatment for 195 eyes (80.2%); however, treatment was only recommended in 18 (7.4%) eyes. One reader was found to differ systematically from the others in indicating treatment (Rasch analysis; p=0.0001). Finally, a significant shift in indication for treatment occurred between birth period 2000-2002 and 2003-2006 (Mann-Whitney rank sum test, p<0.001).

    Conclusions: Inter-reader agreement on central vascular changes is poor, especially when based on more than two rating categories. The subjective nature of diagnosing such vascular changes possibly resulted in earlier treatment of preterm infants in Denmark over the entire study period (1997-2006). The recent increased incidence of treated infants in Denmark is, at least in part, explained by a significant shift in indication for treatment.

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