Clinical Ophthalmology (Jan 2021)
Referral Process in Patients with Uveitis: A Challenge in the Health System
Abstract
Alejandra Villalobos-Pérez,1,* Juliana Reyes-Guanes,2,* Juliana Muñoz-Ortiz,2,3 María Andrea Estévez-Florez,3 Mario Ramos-Santodomingo,3 Valentina Balaguera-Orjuela,3 Alejandra de-la-Torre3 1Universidad del Norte, Barranquilla, Colombia; 2Escuela Barraquer. Research Group, Escuela Superior de Oftalmología del Instituto Barraquer de América, Bogotá, Colombia; 3Research Group in Neuroscience NeURos, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia*These authors contributed equally to this workCorrespondence: Alejandra de-la-TorreResearch Group in Neuroscience NeURos, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Carrera 24 # 63 C 69, Bogotá, ColombiaTel +57 3102482196Email [email protected]: To describe the evaluation and referral process from a group of patients with uveitis presented at a specialized uveitis center in Bogotá, Colombia.Methods: An observational descriptive cross-sectional study was performed. After applying the selection criteria, 315 clinical records were recovered. Univariate and bivariate analyses were used, reporting proportions, means and standard deviations.Results: The mean age of the sample was 45.23 years old and 63.8% of them were females. Patients were mostly referred by retina specialists, general ophthalmologists, rheumatologists, and cornea specialists. Meantime between the first ocular symptom and uveitis specialist evaluation was 2.08 years. Patients had been previously evaluated by a mean of 1.9 ophthalmologists. In 79.9% of patients, inflammation was recognized by the remittent; however, only 4.7% of patients were correctly graded according to SUN classification. At first time consultation with the uvea specialist, 52.1% of the patients arrived with an adequate infectious panel, 58.1% with an adequate rheumatologic panel, 11.6% with aqueous humor PCR study, 65.1% with an initial etiological diagnosis, 34.9% with inadequate topical treatment, and 59.6% with inadequate systemic treatment. The mean time to reach a diagnosis by the uvea specialist was 5.27 weeks (0.10 years). A diagnostic coincidence was not reached in 58.7% of the cases.Conclusion: The referral process to uveitis specialists is complex but highly relevant for those who suffer from this pathology. Health professionals must be aware of the standardized classification of the disease, the appropriate treatment according to the classification, and early referral to the uveologist with adequate laboratory tests.Keywords: uveitis, referral and consultation, ophthalmologists, disease management, diagnosis, Colombia
