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Caroline Minkus, Maxwell Pistilli, Kurt Dreger, Tonetta Fitzgerald, Abhishek Payal, Hosne Begum, R Oktay Kacmaz, Douglas A Jabs, James Rosenbaum, Grace A Levy-Clarke, H Nida Sen, Eric B Suhler, Jennifer E Thorne, Nirali Bhatt, C Stephen Foster, John H Kempen; Incidence and Risk of Cataract Formation in Intermediate Uveitis. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2070.
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To determine the incidence of cataract formation in patients with intermediate uveitis, and evaluate associated risk factors.
Patients were identified from the Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study. Medical records were reviewed to determine patients’ demographic information and clinical data. Patient demographic characteristics, as well as inflammatory exam findings, were compared using statistical models. The primary outcome was development of visually significant cataract as defined by a decrease in visual acuity to 20/40 or less, or requiring cataract surgery.
A total of 2190 eyes from 1302 patients with intermediate uveitis treated at tertiary care uveitis centers were included. The absolute risk of cataract formation was 35.5% at ten years. This was increased in patients with concurrent anterior uveitis causing posterior synechiae (HR=2.68, 95% CI = 2.00-3.59, p<0.001), and in those with epiretinal membrane formation (HR=1.54, 95% CI = 1.15-2.07, p = 0.004). Low dose corticosteroid medications (oral prednisone 7.5mg daily or less, or topical corticosteroid drops less than two times daily) suggested a slightly decreased risk of cataract formation, though this was not statistically significant. Higher doses of corticosteroids significantly increased the incidence of cataract. Patient demographics including age at presentation, race, sex, and smoking status, were not statistically significantly associated with a difference in risk. Similarly, use of several common medications including aspirin, angiotensin converting enzyme inhibitors, nonsteroidal anti-inflammatory medications, and statins, did not confer a difference in risk.
Our study found that the absolute risk of cataract formation in intermediate uveitis is moderate. The risk increases with the presence of concurrent anterior uveitis causing posterior synechiae, and with higher doses of corticosteroid medications.
This is a 2020 ARVO Annual Meeting abstract.
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