Pattern of uveitis in
a referral centre in
Tunisia, North Africa
M Khairallah, S Ben Yahia, A Ladjimi, R Messaoud,
S Zaouali, S Attia, S Jenzeri and B Jelliti
referral centre in Tunisia, North Africa.
MethodsThe study included 472 patients with
uveitis examined at the Department of
Ophthalmology of Monastir (Tunisia) from
January 1992 to August 2003. All patients had
a comprehensive ocular and systemic history,
including an extensive review of medical
systems. Complete ophthalmic examination was
performed in all cases, including best-corrected
Snellen visual acuity, slit-lamp examination,
applanation tonometry, and dilated fundus
examination with three-mirror lens. Standard
diagnostic criteria were employed for all
syndromes or entities of uveitis.
ResultsThe mean age at onset of uveitis was
34 years. The male-to-female ratio was 1:1.1.
Uveitis was unilateral in 282 patients (59.7%)
and bilateral in 190 patients (40.3%). Anterior
uveitis was most common (166 patients; 35.2%),
followed by posterior uveitis (133 patients;
28.2%), panuveitis (100 patients; 21.2%), and
intermediate uveitis (73 patients; 15.5%).
A specific diagnosis was found in 306 patients
(64.8%). The most common cause of anterior
uveitis was herpetic uveitis (56 patients; 33.7%).
Toxoplasmosis was the most frequent cause of
posterior uveitis (51 patients; 38.3%). Inter-
mediate uveitis was most commonly idiopathic
(63 patients; 86.3%). Behc ¸et’s disease was the
most common cause of panuveitis (36 patients;
36%), followed by Vogt–KoyanagiFHarada
(VKH) disease (15 patients; 15%). A total of
16 patients (3.4%) suffered from blindness,
and 59 (12.5%) from uniocular blindness.
ConclusionsIn a hospital population in
Tunisia, the most common causes of uveitis
were Behc ¸et’s disease, herpes simplex
infection, toxoplasmosis, and VKH disease.
Eye (2007) 21, 33–39. doi:10.1038/sj.eye.6702111;
published online 17 February 2006
To analyse the pattern of uveitis in a
Keywords: epidemiology; uveitis; Tunisia; North
Uveitis refers to intraocular inflammation
involving not only the uveal tract but also the
adjacent structures, including the retina and
vitreous. It affects people from all parts of the
world, and it is a significant cause of severe
visual impairment, accounting for 10% of
blindness in the Western world.1The pattern of
uveitis is largely influenced by a multitude of
factors, including genetic, ethnic, geographic,
and environmental factors, diagnostic criteria,
and referral patterns.2It also changes over time
with the emergence or identification of newer
uveitic entities and improvement of diagnostic
Given the continuing globalization of the
world, epidemiological studies on uveitis in
different geographic areas or populations are
important, as their results provide relevant
clinical and research applications. Numerous
studies on pattern of uveitis in various
geographic regions from Western countries and
Asia have been published, showing similarities
and distinct differences in epidemiologic
profiles and aetiologies of uveitis.3–22Data on
uveitis from Africa are scarce,23,24and there
is a lack of studies from the North African
The objective of our study was to identify the
pattern of uveitis in a major university hospital
eye centre in Tunisia, a North African, south
Mediterranean country with 350
ophthalmologists for its 10 millions inhabitants
Materials and methods
The study included 472 consecutive patients
with uveitis who were seen between January
1992 and August 2003 at the Ophthalmologic
Department of Fattouma Bourguiba University
Hospital, Monastir, Tunisia. Our hospital is a
referral centre for a large area, and also a care
centre seeing patients that attend directly the
Received: 18 June 2005
Accepted in revised form:
14 August 2005
17 February 2006
No financial interest
Presented in part at the
American Academy of
Meeting (Orlando, 2002)
Hospital, Monastir, Tunisia
Monastir 5019, Tunisia
Tel: þ216 73 461 144;
Fax: þ216 73 460 678.
Eye (2007) 21, 33–39
& 2007 Nature Publishing Group All rights reserved 0950-222X/07 $30.00
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Pattern of uveitis in Tunisia, North Africa
M Khairallah et al