Abstract
Purpose :
Inflammation relapse in the context of different treatments and etiologies of ocular inflammation is not understood. To discern this, the prevalence of inflammation relapse and the association between different immunosuppressives and etiology of non-infectious ocular inflammatory disease with the duration of quiescence following treatment discontinuation were measured in a retrospective chart review.
Methods :
A retrospective chart review from the University of Ottawa Eye Institute, Ottawa, Ontario, Canada was performed. Inclusion criteria were: patients with non-infectious ocular inflammation (uveitis, scleritis, and episcleritis) and patients with ≥2 visits spanning ≥90 days and follow-up within 12 months. Data from visits was collected at defined time points. For patients who achieved complete remission, the time before treatment discontinuation and the duration of quiescence (after treatment discontinuation) was calculated. For patients with a relapse in inflammation, the time to treatment discontinuation and the duration of quiescence until treatment re-initiation was calculated.
Results :
145 patients (29.3%) were weaned off treatment while 350 patients (70.7%) continued treatment. 125 patients (25.25%) achieved complete remission while 20 patients (4.04%) had a relapse in inflammation. Mycophenolate mofetil had the longest duration of quiescence (68 months) among patients with ocular inflammation with no systemic disease (figure 1). Methotrexate and corticosteroids had the longest durations of quiescence for ocular inflammation with systemic disease (51 and 50.1 months respectively, figure 1). Patients with birdshot chorioretinopathy discontinued treatment after 64 months (the longestest duration) and had an inflammation relapse after 15 months. 40% of patients with scleritis/episcleritis (the highest) achieved complete remission while 1 patient (2.22%) relapsed.
Conclusions :
In this study period, most patients required long term therapy. It was more common to achieve complete remission after discontinuing treatment rather than have an inflammation relapse. Mycophenolate mofetil was the best treatment for ocular inflammation with no systemic disease while methotrexate and corticosteroids were best for ocular inflammation with systemic disease. Patients with scleritis/episcleritis had the best outcomes, while patients with birdshot chorioretinopathy had the poorest outcomes.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.