Purchase this article with an account.
Margaux Guillard, Emilie Perrin, Bridget-Anne Kirwan, Dominique Monnet, Antoine Brezin; Evolution of intra ocular inflammation in treated acute anterior uveitis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5200. doi: https://doi.org/.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
We investigated the evolution of intraocular inflammation in treated anterior uveitis.
Consecutive patients with non infectious acute anterior uveitis (anterior chamber cell grade ≥ 2+) seen between January and April 2012 in a tertiary referral center were investigated. Patients demographics in addition to a detailed ophthalmological medical history was obtained at entry. Patients underwent a complete ophthalmologic examination at all visits and were followed for maximally 35 days.
In total, 54 (100%) patients were included. The mean age was 41 (± 12) years, 43% were male and 9% presented with bilateral uveitis. The most frequent aetiology was HLA-B27-associated uveitis (59%) followed by idiopathic (30%) and sarcoidosis (4%). All patients were treated with topical dexamethasone (1mg/ml) with the number of eye drops determined by the inclusion anterior chamber cell grade. In addition to this treatment, 4 patients (7%) were treated by either systemic corticosteroids and/or immunosuppressant agents. At entry, an anterior chamber cell grade was available for 59 eyes : 6 eyes (10%) had an anterior cell grade of 4+, 16 (27%) an anterior cell grade of 3+ and 37 (63%), an anterior cell grade of 2+. At day 10, an anterior cell grade was available for 58 eyes and for 53 eyes at day 30. At day 10 and day 30, 11 (19%) and 42 (79%) eyes respectively had an anterior cell grade of 0. A decrease of at least 2 grades (anterior cell) was observed in 28 eyes (48%) at day 10 and in 47 eyes (89%) at day 30. None of the baseline characteristics (age, gender) nor the patient’s ophthalmology profile at entry (i.e. time between onset of symptoms and examination by an ophthalmologist, HLA B27 etiology, first uveitis episode vs recurrent episode or systemic treatment in addition to topical corticosteroids) were positive predictors of outcome.
Almost 50% of patients diagnosed with acute uveitis had a reduction of 2 grades or more after 10 days of treatment with at least dexamethasone eye drops. By day 30, almost 80% of patients had no detectable inflammation. Neither the baseline characteristics nor the entry ophthalmology profile influenced evolution of the intraocular inflammation up to 30 days after the initiation of treatment. These data could be used as reference in future controlled trials assessing new treatment methods in acute anterior uveitis.
This PDF is available to Subscribers Only