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Mashal Akhter, Xihui Lin; Etiology and longitudinal outcomes of panuveitis in an inner city underserved population. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4160.
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Panuveitis is defined by inflammation of the uveal tract in both the anterior and posterior segment. Panuveitis generally accounts for less than 25% of all uveitis presenting to tertiary care facilities. Successful treatment relies on consistent follow up and good compliance with treatment. The inner city population presents a unique cohort in which both follow up and treatment compliance are inconsistent. We undertook this study to evaluate the etiology and long term visual outcomes in this cohort to further understand how best to treat panuveitis patients when socioeconomic factors limits management options.
A retrospective chart review was conducted on patients with a diagnosis of panuveitis from January 2012 to January 2017. Factors analyzed included demographics, visual acuity, etiology, degree of posterior involvement, treatment, including steroids, immunomodulatory therapy or intraocular therapy, loss of follow up and sequelae. IRB approval was obtained from the Wayne State University School of Medicine. All subjects were treated in accordance to the Declaration of Helsinki.
101 patients were analyzed: 79% were African-American, 13% were Caucasian and 4% were other. The average age was 50. 68% of the patients were female and 32% were male. 39% of patients had systemic disease, of which sarcoidosis was the most common (49%). 30% of patients were idiopathic and 27% were infectious, of which syphilis was the most common (41%). 78% of patients were on steroids and and 54% were on immunomodulatory medication, of which methotrexate was the most common (43%). There was no significant change in vision after treatment. 25% of patients developed uveitic glaucoma. At least 18% of the patients in our study were lost to follow up two or more times.
The etiology of panuveitis seen in our study, most notably the predominance of sarcoidosis and syphilis, is unique to our inner city population when compared to other studies. This knowledge may help guide treatment in this challenging patient population.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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