LAUSR

Patients presenting with an inflammatory eye disease may have underlying immune-mediated and inflammatory diseases (IMIDs). However, IMIDs are challenging to diagnose. A combined rheumatology-ophthalmology evaluation could enhance detection of IMIDs in this group.To investigate whether the implementation of a combined rheumatology-ophthalmology clinic could increase the sensibility of IMIDs diagnosis.A combined rheumatology-ophthalmology clinic started in January 2020. A rheumatologist with expertise in IMIDs assessed outpatients of a tertiary care ophthalmologic clinic specialised in inflammatory eye disease consecutively referred between 01/01/20 and 31/12/20. Two separate visits confirmed both ophthalmology and rheumatology diagnoses. The same period of the year 2019 was used as a comparator.We noticed a three-fold increase in the number of ophthalmology patients who underwent an evaluation with a rheumatologist in 2020 compared to 2019 (41 vs 13, +315%; Table). There were no differences in sex distribution or age between the two years. However, the median time before rheumatology assessment was shorter in 2020 than 2019 (median days 0 [range 0-6] vs 12 [range 0-91]). IMIDs diagnoses increased by 27% in 2020 compared to 2019 (29/41 vs 7/13, 71% vs 54%), mainly driven by new diagnoses of systemic vasculitis and Behcet’s disease (Figure 1). There was also an increase in diagnoses of non-IMIDs systemic conditions (3 cancers and one infection in 2020 vs none in 2019). After rheumatology evaluation, immune-modulating therapy was initiated in 18/41 (44%) vs 3/13 (23%).Ophthalmology assessment and referrals to rheumatologyReferrals2019(n=13)Referrals2020(n=41)Inflammatory eye disease, n (%)6 (46)36 (88)Uveitis, n621Vasculitis, n24AION, n35Conjunctivitis, n10Scleritis, episcleritis, n01Other, n15An integrated approach with rheumatologist appeared to remarkably increase the likelihood to detect IMIDs among patients presenting with inflammatory eye diseases.None declared