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J Fernando Arevalo, Andres Lasave, Hanan Al-Shamsi, Sulaiman Al Sulaiman, Abdulaziz Alrushood, Yahya Alzahrani, Vishali Gupta, Ammar Al-Mahmood, Hassan Al Dhibi, ; Characteristics, Complications, and Surgical Outcomes of Panuveitis in 400 patients (727 eyes) over 25 Years: The KKESH Uveitis Survey Study Group. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5387.
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To describe clinical characteristics, complications, and surgical outcomes of panuveitis in a tertiary center over a 25-year period.
Retrospective chart review study. Four-hundred patients (727 eyes) with panuveitis were evaluated from January 1986 through December 2011 in a tertiary center.
The type of panuveitis was granulomatous in 206 (51.5%) patients, and in 194 (48.5%) patients non-granulomatous. The etiology was infectious in 61 (15.3%), and non infectious in 339 (84.4%) patients. Mean age was 37.7 ± 14.6 (7 to 88) years. Episodes were bilateral in 290 patients (72.5 %). Baseline best-corrected visual acuity (BCVA) was 20/125 (logMAR 0.8 ± 0.67) in both eyes. BCVA of 20/200 or worse at presentation occurred in 280 (38.5%) eyes. Onset was sudden in 234 (58.5%) patients. Symptoms duration was short (< 3 months) in 185 (46.3%) patients. A single episode occurred in 159 (39.8%) patients, and recurrent in 241 (60.3%) patients. Clinical diagnosis included Vogt-Koyanagi-Harada syndrome (VKH) in 151 (37.8%) patients, Behcet's disease in 104 (26%) patients, idiopathic panuveitis in 33 (8.3%) patients, presumed-intraocular tuberculosis (PIOTB) in 21 (5.3%) patients, chronic postoperative panuveitis in 12 (3%) patients, toxoplasmic retinochoroiditis in 9 (2.3%) patients, sympathetic ophthalmia in 5 (1.8%) patients, and 63 (15.8%) patients with no clear diagnosis at presentation. Oral prednisone was the first line of treatment in 295 (87%) with non-infectious etiology followed by immunosuppressive agents. One hundred eighty-one (45.3%) patients underwent surgical procedures secondary to complications; 140 (74.9%) patients due to cataracts. Twenty-three (12.3%) patients underwent pars plana vitrectomy, and 18 (9.6%) patients surgical glaucoma procedures. Mean final visit BCVA in both eyes was 20/100 (logMAR 0.7± 0.92).
VHK and Behcet's disease are the leading causes of panuveitis in Saudi Arabia. Immunosuppressive therapy and surgical intervention helped maintain BCVA in panuveitis patients long-term.
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