June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Incidence of Cataract in Eyes with Anterior Uveitis
Author Affiliations & Notes
  • John H Kempen
    Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
    Ophthalmology, MyungSung Christian Medical Center and Medical College, Addis Ababa, Ethiopia
  • George N. Papaliodis
    Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
  • Bernard Rosner
    Biostatistics, Channing Laboratory, Harvard Medical School, Boston, Massachusetts, United States
  • Kurt Dreger
    Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Gui-Shuang Ying
    Ophthalmology, Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • C Stephen Foster
    Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, United States
  • Douglas A Jabs
    Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
    Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, United States
  • James Rosenbaum
    Casey Eye Institute, Oregon Health & Sciences University, Portland, Oregon, United States
  • Grace A Levy-Clarke
    Tampa Bay Uveitis Center, Tampa, Florida, United States
  • H Nida Sen
    National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
  • Eric B Suhler
    Casey Eye Institute, Oregon Health & Sciences University, Portland, Oregon, United States
    Ophthalmology, Portland VA Medical Center, Portland, Oregon, United States
  • Jennifer E Thorne
    Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, United States
    Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Nirali Bhatt
    Ophthalmology, Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   John Kempen, None; George Papaliodis, None; Bernard Rosner, None; Kurt Dreger, None; Gui-Shuang Ying, None; C Stephen Foster, None; Douglas Jabs, None; James Rosenbaum, None; Grace Levy-Clarke, None; H Nida Sen, None; Eric Suhler, None; Jennifer Thorne, None; Nirali Bhatt, None
  • Footnotes
    Support  NEI Grant EY014943 (Kempen); NEI Grant EY02445 (Rosner)
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 2069. doi:
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      John H Kempen, George N. Papaliodis, Bernard Rosner, Kurt Dreger, Gui-Shuang Ying, C Stephen Foster, Douglas A Jabs, James Rosenbaum, Grace A Levy-Clarke, H Nida Sen, Eric B Suhler, Jennifer E Thorne, Nirali Bhatt; Incidence of Cataract in Eyes with Anterior Uveitis. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2069.

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

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Abstract

Purpose : To identify the incidence of and risk factors for cataract in eyes with anterior uveitis

Methods : Retrospective cohort study of eyes with anterior uveitis followed at five US tertiary uveitis facilities. We evaluated the incidence of cataract in patients with anterior uveitis. Cataract was defined in two ways: newly reduced visual acuity worse than 20/40 attributed to cataract; and/or incident cataract surgery. The secondary objective was to evaluate factors potentially predictive of cataract development.

Results : Among 4677 eyes (of 2993 patients) with anterior uveitis, 546 (11.7%) had primary anterior uveitis, 2312 (49.4%) recurrent anterior uveitis, and 1819 (38.9%) chronic anterior uveitis. 773 eyes (16.5%) developed cataract; 309 (6.6%) were identified due to visual acuity reduction worse than 20/40 and 464 (9.9%) based on occurrence of cataract surgery. The incidence rate for the first of these events was 3.75%/eye-year over the first 8 years of the study. Factors predictive of increased risk of cataract development included: age over 65 (adjusted hazard ratio (HR), 4.79; 95% CI, 2.95-7.77), higher grade of anterior chamber (AC) cell score at the previous visit (0.5+ vs 0, HR, 0.92; 1+ vs 0, HR, 2.54, 95% CI 1.66-3.91; ≥2+ vs 0 grade–HR, 3.10; 95% CI, 2.00-4.80), prior incisional glaucoma surgery (HR, 1.70; 95% CI, 1.03-2.80), presence of band keratopathy (HR, 2.16; 95% CI, 1.42-3.27), presence of posterior synechiae (HR, 3.43; 95% CI, 2.65-4.43), and highly elevated intraocular pressure (IOP≥30 mmHg vs. 6-20 mmHg —HR, 2.27; 95% CI, 1.18-4.37). Use of topical corticosteroids was not associated with higher cataract risk in the presence of grade 1+ or higher AC cells. In eyes with grade 0 AC cells, ≥2 drops/day (HR, 2.01, 95% CI, 1.42-2.85) but not >0 but <2 drops/day (HR, 1.31, 95% CI, 0.77-2.23) were associated with increased cataract risk. In eyes with grade 0.5+ AC cells, both ≥2 drops/day (HR, 2.29, 95% CI, 1.09-4.81) and >0 but <2 drops/day (HR, 2.89, 95% CI: 1.06-7.86) were associated with increased cataract risk.

Conclusions : Cataract occurred in 3.75%/eye-year within the first 8 years of observation. Cataract risk factors include advanced age, high anterior chamber cell grade, prior incisional glaucoma surgery, presence of band keratopathy, presence of posterior synechiae, and IOP≥30 mmHg. Topical corticosteroids were associated with increased cataract risk only when anterior chamber cells were absent or minimally present.

This is a 2020 ARVO Annual Meeting abstract.

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