June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Incidence and Risk of Cataract Formation in Intermediate Uveitis
Author Affiliations & Notes
  • Caroline Minkus
    Massachusetts Eye and Ear, Boston, Massachusetts, United States
    Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, United States
  • Maxwell Pistilli
    Department of Ophthalmology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
  • Kurt Dreger
    Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
    Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States
  • Tonetta Fitzgerald
    Department of Ophthalmology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
  • Abhishek Payal
    Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States
    Massachusetts Eye Research and Surgery Institute, Waltham, Massachusetts, United States
  • Hosne Begum
    Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States
  • R Oktay Kacmaz
    Massachusetts Eye and Ear, Boston, Massachusetts, United States
    Massachusetts Eye Research and Surgery Institute, Waltham, Massachusetts, United States
  • Douglas A Jabs
    Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • James Rosenbaum
    Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon, United States
    Department of Medicine, Oregon Health and Science University, Portland, Oregon, United States
  • Grace A Levy-Clarke
    Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
    Tampa Bay Uveitis Center, St. Petersburg, Florida, United States
  • H Nida Sen
    Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
  • Eric B Suhler
    Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon, United States
    Portland Veteran's Affairs Medical Center, Portland, Oregon, United States
  • Jennifer E Thorne
    Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland, United States
    Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Nirali Bhatt
    Department of Ophthalmology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States
  • C Stephen Foster
    Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
    Massachusetts Eye Research and Surgery Institute, Waltham, Massachusetts, United States
  • John H Kempen
    Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, United States
    Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Caroline Minkus, None; Maxwell Pistilli, None; Kurt Dreger, None; Tonetta Fitzgerald, None; Abhishek Payal, None; Hosne Begum, None; R Oktay Kacmaz, None; Douglas Jabs, None; James Rosenbaum, Abbvie (C), Alcon Research Institute (F), Eyeevensys (C), Gilead (C), Janssen (C), Novartis (C), Pfizer (F), Roche (C), UpToDate (C); Grace Levy-Clarke, Abbvie (C), Abbvie (R), Allergan (F), Mallinckrodt (C), Mallinckrodt (F), Sanofi (F), Sanofi (R); H Nida Sen, None; Eric Suhler, Abbvie (C), Abbvie (F), Clearside (C), Clearside (F), Eyeevensys (C), EyeGate (C), EyeGate (F), EyePoint (C), EyePoint (F), Santen (C); Jennifer Thorne, Abbvie (C); Nirali Bhatt, None; C Stephen Foster, None; John Kempen, Clearside (C), Gilead (C), Santen (C)
  • Footnotes
    Support  NIH grant R21 EY026717; NIH Grant 2P30EYEY001583; support from Massachusetts Eye and Ear Global Surgery Program; support from Sight for Souls; support from Research to Prevent Blindness
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 2070. doi:
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    • Get Citation

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

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Abstract

Purpose : To determine the incidence of cataract formation in patients with intermediate uveitis, and evaluate associated risk factors.

Methods : 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.

Results : 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.

Conclusions : 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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