April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Visual acuity outcome of non-infectious intermediate, posterior, and panuveitis in the Multicenter Uveitis Steroid Treatment (MUST) Trial
Author Affiliations & Notes
  • John H Kempen
    Ophthal-Biostatistics & Epidemiol, Scheie Eye Inst/Univ of Penn, Philadelphia, PA
  • Mark L Van Natta
    Epidemiology, Center for Clinical Trials, Johns Hopkins University Bloomberg School of Public Heatlh, Baltimore, MD
  • Michael M Altaweel
    Ophthalmology, Fundus Photograph Reading Center, University of Wisconsin, Madison, WI
  • James P Dunn
    Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
  • Douglas A Jabs
    Epidemiology, Center for Clinical Trials, Johns Hopkins University Bloomberg School of Public Heatlh, Baltimore, MD
    Ophthalmology and Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
  • Susan Lightman
    Institute of Ophthalmology, University College London, London, United Kingdom
  • Jennifer E Thorne
    Epidemiology, Center for Clinical Trials, Johns Hopkins University Bloomberg School of Public Heatlh, Baltimore, MD
    Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
  • Janet T Holbrook
    Epidemiology, Center for Clinical Trials, Johns Hopkins University Bloomberg School of Public Heatlh, Baltimore, MD
  • Footnotes
    Commercial Relationships John Kempen, None; Mark Van Natta, None; Michael Altaweel, None; James Dunn, None; Douglas Jabs, None; Susan Lightman, None; Jennifer Thorne, None; Janet Holbrook, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 6036. doi:
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    • Get Citation

      John H Kempen, Mark L Van Natta, Michael M Altaweel, James P Dunn, Douglas A Jabs, Susan Lightman, Jennifer E Thorne, Janet T Holbrook, ; Visual acuity outcome of non-infectious intermediate, posterior, and panuveitis in the Multicenter Uveitis Steroid Treatment (MUST) Trial. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6036.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To identify factors predicting 2-year best-corrected visual acuity (BCVA) outcome of non-infectious intermediate, posterior, and panuveitis.

 
Methods
 

In the Multicenter Uveitis Steroid Treatment (MUST) Trial, subjects with active or recently active (within 60 days) intermediate (+/- anterior), posterior or panuveitis for which systemic corticosteroid therapy was indicated were randomized to treatment with standardized systemic therapy or fluocinolone acetonide implant therapy. BCVA was measured by masked examiners at baseline and 2 years’ follow-up using gold standard methods. Data regarding characteristics possibly predictive of changes in visual acuity were derived via the standard study protocol administered across the 23 clinical centers.

 
Results
 

Among 479 uveitic eyes (of 255 patients) enrolled, 431 had baseline and two year BCVA data, two of which were excluded because of no light perception at baseline. By two years, eyes better than 20/50 and 20/50 or worse at baseline improved a mean of 0.2 lines (p=0.52) and 2.0 lines (p<0.001) respectively. The implant and systemic groups improved to a similar degree. Anterior/intermediate uveitis (mean=1.2 lines, p=0.11), intermediate uveitis (mean=0.6 lines, p=0.12), posterior uveitis (mean=1.0 lines, p=0.03), and panuveitis cases (mean=1.0 lines, p=0.003) all improved on average (p(difference amongst the groups)=0.84). Factors predictive of improved BCVA included resolution of active anterior chamber cells (mean=2.6 lines, p<0.001) and flare (mean=1.4 lines, p=0.06), and resolution of vitreous haze (mean=1.4 lines, p=0.05), posterior synechiae (reflecting interval cataract surgery, mean=2.6, p=0.001), and macular thickening (mean=2.4 lines, p<0.001).

 
Conclusions
 

While receiving standardized systemic or fluocinolone acetonide implant therapy, the average anterior/intermediate, intermediate, posterior, or panuveitis case presenting with poor BCVA improved, while the average case presenting with normal BCVA retained normal BCVA. Control of anterior chamber and vitreous inflammation, cataract surgery (when indicated) and resolution of macular edema were associated with improvement over a two year interval.

  
Keywords: 746 uveitis-clinical/animal model • 462 clinical (human) or epidemiologic studies: outcomes/complications • 466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials  
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