June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
The Prevalence, Incidence and Risk Factors for Exudative Retinal Detachment in Uveitis
Deepika Shah; Craig Newcomb; Grace Levy-Clarke; Robert Nussenblatt; James Rosenbaum; Eric Suhler; Jennifer Thorne; C. Stephen Foster; Douglas Jabs; John Kempen
Author Affiliations & Notes
  • Deepika Shah
    Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA
  • Craig Newcomb
    Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA
  • Grace Levy-Clarke
    National Eye Institute, Laboratory of Immunology, National Institutes of Health, Bethesda, MD
  • Robert Nussenblatt
    National Eye Institute, Laboratory of Immunology, National Institutes of Health, Bethesda, MD
  • James Rosenbaum
    Ophthalmology, National Institutes of Health, Bethesda, MD
    Medicine, Oregon Health and Science University,, Portland, OR
  • Eric Suhler
    Ophthalmology, National Institutes of Health, Bethesda, MD
    Ophthalmology, Portland Veteran’s Affairs Medical Center8,, Portland, OR
  • Jennifer Thorne
    Ophthalmology, The Johns Hopkins University,, Bethesda, MD
    Epidemiology, The Johns Hopkins University,, Bethesda, MD
  • C. Stephen Foster
    Ophthalmology, Massachusetts Eye Research and Surgery Institution, Cambridge, MA
    Ophthalmology, Masachussets Eye and Ear Infirmary, Harvard Medical School, New York, NY
  • Douglas Jabs
    Medicine, Mount Sinai School of Medicine, New York, NY
    Ophthalmology, Mount Sinai School of Medicine, New York, NY
  • John Kempen
    Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA
    Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA
  • Footnotes
    Commercial Relationships Deepika Shah, None; Craig Newcomb, None; Grace Levy-Clarke, Johnson and Johnson Vision Care (E); Robert Nussenblatt, None; James Rosenbaum, Genentech (C), Abbott (F), Xoma (C), Eyegate (F), Bristol Myers (F), Lux (C), Novartis (C), Regeneron (C), Teva (C), Therakine (F), Mitotech (F), Aquinox (F), Allergan (C), Santen (C); Eric Suhler, Abbott (F), Abbott (C), Bristol-Myers-Squibb (F), EyeGate (F), Genentech (F), LuxBio (F), LuxBio (C), Eleven Biotherapeutics (C), XOMA (F); Jennifer Thorne, Allergan (C), XOMA (C), Santen (C); C. Stephen Foster, Abbott Medical Optics (C), Abbott Medical Optics (F), Alcon Laboratories, Inc. (C), Alcon Laboratories, Inc. (F), Allergan, Inc. (C), Allergan, Inc. (F), Eyegate Pharmaceuticals, Inc. (I), Eyegate Pharmaceuticals, Inc. (F), IOP Opthalmics (C), Ista Pharmaceuticals (C), Lux Biosciences, Inc. (C), Lux Biosciences, Inc. (F), Novartis Pharmaceuticals Corporation (C), Novartis Pharmaceuticals Corporation (F), XOMA Ltd (C); Douglas Jabs, Alcon (C), Allergan Uveitis Board (C), Abbott Laboratories (C), Genzyme Corporation (C), Novartis (C), Applied Genetic Technologies Corporation (C), Roche (C), GlaxoSmithKline (C), Genentech (C), Cocerpt (C), Regeneron (C); John Kempen, Alcon (C), Allergan (C), Clearside (C), Can-Fite (C), Lux Biosciences (C), Xoma (C), NEI/NIH (F), FDA (F), Research to Prevent Blindness (F), Mackall Foundation (F), EyeGate Pharma (F), University of Pennsylvania (E)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 2939. doi:
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      Deepika Shah, Craig Newcomb, Grace Levy-Clarke, Robert Nussenblatt, James Rosenbaum, Eric Suhler, Jennifer Thorne, C. Stephen Foster, Douglas Jabs, John Kempen; The Prevalence, Incidence and Risk Factors for Exudative Retinal Detachment in Uveitis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2939.

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Abstract

Purpose: To evaluate the prevalence, incidence, and risk factors associated with exudative retinal detachment (ERD) in patients with uveitis.

Methods: We performed a retrospective chart review of a large multi-center cohort (Systemic Immunosuppressive Therapy for Eye Disease Cohort Study) of patients with ocular inflammation at four tertiary care academic ocular inflammation centers in the US between 1978 and 2007, evaluating the prevalence, incidence and risk factors for ERD.

Results: 138 of 8478 uveitic patients presented with prevalent ERD (1.6%). Risk factors for prevalent ERD were Vogt-Koyanagi-Harada syndrome (VKH) (odds ratio (OR) 80.92, p<0.0001), sympathetic ophthalmia (SO) (OR 8.01, p=0.0064), retinochoroiditis (OR 8.92, p<0.0001), panuveitis (OR 6.14, p<0.0001),posterior uveitis (OR 12.36, p<0.0001), posterior scleritis (OR 30.33, p<0.0001), and necrotizing scleritis(OR 5.75, p=0.0213). Clinical features predictive of ERD were choroidal neovascularization (OR 2.61, p=0.0219) and band keratopathy (OR 2.89, p=0.0007). Among the 5409 uveitic patients with follow-up and initially free of ERD, 105 incident ERD cases were observed (incidence rate=0.65%/person-year). Among the ocular inflammatory diagnoses, only retinochoroiditis (hazard ratio (HR) 7.13, p=0.0014) was significantly associated with incident ERD. VKH (HR=3.88, p=0.21), SO (HR=3.27, p=0.32), and posterior scleritis (4.46, p=0.14) had increased incidence, but not to a statistically significant degree. Systemic diagnoses of rheumatoid arthritis (HR 2.39, p=0.0367) and juvenile idiopathic arthritis (HR 2.35, p=0.0402) had higher incidence of ERD. In both the prevalence (OR=4.36, p<0.0001) and incidence analyses (HR=2.80, p<0.0001), active inflammation was associated with higher risk of ERD. In the incidence analysis, a dose-response relationship with ERD incidence was observed for time-updated anterior chamber cell grade, and for vitreous cell grade, as well as a higher risk among cases with vitreous haze.

Conclusions: ERD is a rare finding strongly, not only associated at presentation with VKH and posterior scleritis, but also with active inflammation, other forms of chorioretinal or scleral inflammation. These results are informative in indicating that an important number of ERD cases are unrelated to VKH or posterior scleritis, especially following initial presentation, and confirm the importance of controlling inflammation to avoid ERD.

Keywords: 746 uveitis-clinical/animal model • 697 retinal detachment • 555 immunomodulation/immunoregulation  
© 2013, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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