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Dina Gewaily, Craig Newcomb, Grace Levy-Clarke, Robert B. Nussenblatt, James T. Rosenbaum, Eric B. Suhler, Jennifer E. Thorne, C Stephen Foster, Douglas A. Jabs, John H. Kempen; Remission Of Intermediate Uveitis: Rate And Predictive Factors. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5478.
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To evaluate the incidence of remission among patients with intermediate uveitis, as well as factors potentially predictive of remission.
A retrospective cohort study using standardized chart review data was performed. Patients with primary non-infectious intermediate uveitis presenting to 1 of 4 academic ocular inflammation subspecialty practices were included. Remission of intermediate uveitis was the primary outcome, defined as lack of inflammatory activity at ≥2 visits spanning ≥90 days in the absence of any anti-inflammatory medications. Factors potentially predictive of intermediate uveitis remission were evaluated using survival analysis, including Cox multiple regression.
We identified 434 patients with intermediate uveitis who were followed for over 925 person-years, during which time the incidence rate of intermediate uveitis remission was 9.4 per 100 person-year (95% confidence interval, 7.5-11.6). The majority (82%) of patients experienced bilateral intermediate uveitis at least once during their clinical course. There was a low frequency of associated systemic disease diagnosed. Factors predictive of disease remission included prior pars plana vitrectomy (PPV) (20.9 per 100 person-years, HR (vs. no PPV)=2.71; 95% CI, 1.64-4.47; Figure) and diagnosis of intermediate uveitis within the last year (34.1 per 100 person-years, HR (vs. diagnosis >5 years ago)=4.12, 95% CI: 1.89-8.95).
Our results suggest that intermediate uveitis is a chronic disease with an overall low rate of remission. Patients presenting early in their disease course are more likely to gain remission than patients who already have had ongoing activity without remission for several years at the time of initial presentation. With regards to management, pars plana vitrectomy was associated with increased probability of remission, but a large number of cases that received vitrectomy continued to have ongoing disease activity.
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