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Elliot S Crane, May Shum, Eliott Kim, Jason Kim, Alexander B Crane, David S. Chu; Epidemiology and Long Term Outcomes of Intermediate Uveitis Treated with Systemic Immunomodulatory Therapy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4197.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the features, treatment outcomes, and complications of intermediate uveitis.
This is a retrospective case series of patients with intermediate uveitis and pars planitis identified at the Metropolitan Eye Research and Surgery Institute and Rutgers New Jersey Medical School between 2011 and 2017 with at least 30 months of follow up. Epidemiology, associated inflammatory conditions, complications, visual outcome, and intraocular inflammation data were recorded and analyzed. Modified logMAR notation was used for calculations involving best corrected visual acuity (BCVA). We considered active inflammation as a grade of 1+ or worse in any of anterior chamber cell or flair, or vitreous cell or haze. From 38 patients identified with intermediate uveitis, 24 met inclusion criteria. Additional follow up data were included up to November 2017.
Twenty-four patients were included (14 [58%] female, mean age 31 ± 18 years at first visit, mean follow up time 6.6 ± 3.4 years). Seventeen (71%) were treated with methotrexate, 8 (33%) with adalimumab, and 6 (25%) with mycophenolate mofetil. Seventy-five percent of our patients required intraocular surgery or injections and many developed cataracts (18, 75%) and glaucoma (9, 38%). Most patients had no associated systemic inflammatory condition (15, 63%). Three (13%) were diagnosed with sarcoidosis, two (8%) each with multiple sclerosis and Lyme disease, and one (4%) each had Crohn’s disease and was HLA-B27 positive. Fifteen (63%) patients had active inflammation on first visit; the inflammation resolved by second visit for five (33%) patients. Twenty-three of 24 (96%) and 23/24 (96%) patients had at least 20/50 BCVA at their 1 year and last visit, respectively. All 24 (100%) and 23/24 (96%) patients had at least 20/200 BCVA at their 1 year and last visit, respectively.
Ocular inflammation in most patients with intermediate uveitis can be effectively managed with systemic anti-inflammatory treatment with good visual outcomes.
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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