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Salam Bachour, Parisa Emami Naeini, Sumit Sharma, Kimberly Baynes, Arthi Venkat, Careen Lowder, Sunil K Srivastava; Clinical and imaging outcomes of patients with retinal vasculitis. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1710.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the long term clinical outcomes in retinal vasculitis patients
This is an IRB approved retrospective study of retinal vasculitis patients seen at the Cole Eye Institute between the years of 2009-20018. Clinical outcomes were gathered from electronic medical records. Characteristics of patients included sex, age, clinical activity, associated systemic etiologies, and time of diagnosis. Outcomes for patients with minimum of 12 month follow up were analyzed. Outcomes included visual acuity, flares observed, number of injections, medications, and intraocular surgeries. Presence of complications including cystoid macular edema, epiretinal membrane, and steroid-induced glaucoma were also collected. Imaging modalities was also reviewed and analyzed.
261 eyes of 145 patients (88 females) were identified for this study. 117 patients presented with bilateral involvement. Average age at presentation was 45.7 years. Mean follow-up time was 41.3±25.6 months. At last visit, 27 patients (19%) had activity upon exam, and 49 cases were still considered idiopathic (34.02%). 96 patients had a confirmed systemic disease, of which, 49 were diagnosed after initial presentation. Top confirmed diagnoses included sarcoidosis (11.81%), behcet’s (8.33%), systemic lupus erythematosus (5.56%), and multiple sclerosis (5.56%). 200 eyes of 109 patients were included for outcome analysis. We observed a median of 0.5 [0.25,1.0] ophthalmic flares per eye years and 0.167 [0,0.5] injections per eye years. 88 patients (80%) required systemic immune suppression, 34 patients (31.2%) developed steroid induced glaucoma, 90 eyes (45%) developed cystoid macular edema (0.18 CME events per eye years) at one point of their disease course, and 51 eyes (25.5%) developed epiretinal membrane over course of disease. Mean logMAR visual acuity was 0.39 at presentation and 0.47 at 2-year follow up.
This study shows a high association between retinal vasculitis and a known systemic cause, with over half of the diagnoses made after initial clinical presentation. Systemic immune suppression was required in a large majority of patients, leading to excellent control of inflammation and relatively low number of flares per eye year—indicating its significant role in the management of this disease.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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