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Elliot Crane, May Shum, Jason S. Kim, Eliott Kim, Alexander B Crane, David S Chu; Visual Acuity and Inflammation Outcomes in Intermediate Uveitis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3312. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze the correlation between ocular inflammation, visual acuity, and disease treatment in subjects with intermediate uveitis and pars planitis (IU).
This is a retrospective cohort study. Billing records from a uveitis specialist in New Jersey were used to identify 45 subjects with intermediate uveitis and pars planitis seen between April of 2003 and February of 2015. 8 subjects met exclusion criteria of less than 6 months of follow up. Trends in visual acuity (VA) were calculated via modified logMAR notation. Inflammation was considered active when a grade of 1+ or worse was assigned to anterior chamber cell or flair, or vitreous cell or haze. Any discrete period of active inflammation between quiescent periods was considered a peak of disease recurrence; the number of these per year of subject follow up are peaks per year (PPY). Calculations were done using Microsoft Excel Version 14.0.1762.5000, MATLAB version 126.96.36.1995. Fisher’s exact tests done with GraphPad Software 2015; P<0.05 was considered significant.
Thirty-seven subjects were identified with intermediate uveitis or pars planitis (16 male, 21 female, mean age 38 +/- 20 years at first visit, mean follow up time 4.6 +/- 3.3 years). 26 (70%) were treated with methotrexate, 8 (22%) were treated with Humira, and 7 (19%) were treated with cellcept. The right eye (RE) and left eye (LE) improved by an average of 0.31 (+/- 6.0 standard deviation [SD]) and 0.77 (+/- 5.1 SD) lines of vision, respectively. 20 (54%) subjects had a worse VA during their final visit in at least one eye than during their initial visit; these subjects experienced significantly more glaucoma (4.9 times, P<0.05), but similar rates of macular edema and cataracts (p>0.05) than subjects with unchanged or improved VAs in both eyes. Only 3 (8.1%) subjects had a worse VA during their final visit in both eyes than during their initial visit. 19 (51%) REs and 24 (65%) LEs experienced peaks of disease recurrence; of those, the REs experienced a mean of 0.73 (+/- 0.52 SD) PPY with each peak lasting 84 (+/- 107 SD) days and the LEs experienced a mean of 0.79 (+/- 0.66 SD) PPY with each peak lasting 83 (+/- 160 SD) days.
Ocular inflammation and peaks of disease recurrence in patients with IU can be effectively managed with aggressive antiinflammatory treatment with good visual outcomes.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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