July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Factors Predictive of Remission of Chronic Anterior Uveitis
Author Affiliations & Notes
  • Lucia Sobrin
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Maxwell Pistilli
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Srishti Kothari
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
    Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, United States
  • Naira Khachatryan
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
    Massachusetts Eye Research and Surgery Institute, Waltham, Massachusetts, United States
  • Pichaporn Artornsombudh
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
    Massachusetts Eye Research and Surgery Institute, Waltham, Massachusetts, United States
  • Siddharth Pujari
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
    Massachusetts Eye Research and Surgery Institute, Waltham, Massachusetts, United States
  • Charles Stephen Foster
    Massachusetts Eye Research and Surgery Institute, Waltham, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Douglas A Jabs
    Ophthalmology and Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States
    Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • James T Rosenbaum
    Ophthalmology and Medicine, Oregon Health and Science University, Portland, Oregon, United States
    Devers Eye Institute, Portland, Oregon, United States
  • Grace Levy-Clarke
    The Tampa Bay Uveitis Center, St. Petersburg, Florida, United States
    Laboratory of Immunology, National Eye Institute, Bethesda, Maryland, United States
  • H Nida Sen
    Laboratory of Immunology, National Eye Institute, Bethesda, Maryland, United States
  • Eric B Suhler
    Ophthalmology, Oregon Health and Science University, Portland, Oregon, United States
    Ophthalmology, Portland Veterans Affairs Medical Center, Portland, Oregon, United States
  • Jennifer E Thorne
    Ophthalmology, The Johns Hopkins School of Medicine, Baltimore, Maryland, United States
    Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Nirali P Bhatt
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • John H Kempen
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
    MCM Eye Unit, MyungSung Christian Medical Center and College, Addis Ababa, Ethiopia
  • Footnotes
    Commercial Relationships   Lucia Sobrin, None; Maxwell Pistilli, None; Srishti Kothari, None; Naira Khachatryan, None; Pichaporn Artornsombudh, None; Siddharth Pujari, None; Charles Foster, None; Douglas Jabs, None; James Rosenbaum, Abbvie (C), Alcon Research Institute (F), Eyevensys (C), Gilead (C), Janssen (C), Novartis (C), Pfizer (F), Roche (C), UpToDate (C); Grace Levy-Clarke, Abbvie (C), Allergan (F), Mallinckrodt (F); H Nida Sen, None; Eric Suhler, Abbvie (C), Abbvie (F), Clearside (C), Clearside (F), EyeGate (C), EyeGate (F), EyePoint (C), EyePoint (F), Eyevensys (C), Santen (C); Jennifer Thorne, Abbvie (C); Nirali Bhatt, None; John Kempen, Clearside (C), Gilead (C), Santen (C)
  • Footnotes
    Support  NEI/NIH Grant EY014943; Research to Prevent Blindness; NEI Intramural Support; Department of Veterans' Affairs; NIH Grant 2P30EY001583; Massachusetts Eye and Ear Global Surgery Program; Sight for Souls; Christoffel Blindenmission
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6683. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Lucia Sobrin, Maxwell Pistilli, Srishti Kothari, Naira Khachatryan, Pichaporn Artornsombudh, Siddharth Pujari, Charles Stephen Foster, Douglas A Jabs, James T Rosenbaum, Grace Levy-Clarke, H Nida Sen, Eric B Suhler, Jennifer E Thorne, Nirali P Bhatt, John H Kempen; Factors Predictive of Remission of Chronic Anterior Uveitis. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6683.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : To estimate the incidence of medication-free remission of chronic anterior uveitis and to identify predictors thereof.

Methods : The Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Study is a retrospective cohort study of patients with ocular inflammatory diseases seen at 5 tertiary referral centers in the United States. Standardized chart review methods were used to identify all patients diagnosed with chronic anterior uveitis. The main outcome measure was incidence of medication-free remission. Remission was defined as inactive uveitis off treatment at all visits spanning an interval of at least 90 days or—for patients who did not return for follow-up after 90 days—remaining inactive without receiving suppressive medications at all of their last visits. Estimation of remission incidence and identification of associated predictors used survival analysis.

Results : 2364 eyes were included in the study. The cumulative medication-free remission incidence within 5 years was 49.4% [95% Confidence Interval (CI), 46.9% - 52.0%]. Clinical factors at baseline that were predictive of less remission included: longer duration of uveitis prior to presentation [adjusted hazard ratio (aHR), 0.72; 95% CI, 0.56-0.92; for 2-5 years vs. less than 6 months)], presence of vitreous cells (aHR, 0.66; 95%, CI 0.49–0.89, for 1+ vs. no cell), prior cataract surgery (aHR, 0.73; 95% CI, 0.61–0.88), and prior glaucoma surgery (aHR, 0.62; 95% CI, 0.46–0.83). Time-updated clinical factors that were predictive of less remission included: keratic precipitates (aHR, 0.41; 95% CI 0.27–0.63), band keratopathy (aHR, 0.73; 95% CI, 0.57–0.93), and synechiae (aHR, 0.53; 95% CI, 0.36-0.79). Systemic diagnosis with Behçet Disease (aHR, 0.25; 95% CI, 0.08-0.80) was also associated with a lower incidence of uveitis remission.

Conclusions : Approximately half of chronic anterior uveitis cases remitted within five years. Longer duration of uveitis, higher grade of vitreous cells, prior cataract surgery, prior glaucoma surgery, presence of keratic precipitates, band keratopathy, iris synechiae, and diagnosis with Behçet Disease predict less remission; cases with these factors should be managed taking into account the higher probability of a longer disease course.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×