Abstract
Purpose :
Uveitis is the fourth leading cause of preventable blindness among adults in the United States. We aim to determine risk factors associated with visual acuity outcomes in uveitic patients.
Methods :
A retrospective study of patients with ocular inflammation from 01/2011 to 12/2016 at Robert Cizik Eye Clinic was done. Those with inflammation caused by rebound post-surgical inflammation or less than 24 months of follow up were excluded. If both eyes were eligible, both were included. Eyes were classified into anterior, intermediate, posterior, panuveitis, and scleritis. Demographics and baseline medical and ocular characteristics were recorded. Ocular symptoms, best corrected visual acuity (BCVA) and additional procedures were collected at follow-up. Risk factors, including demographics, ocular history, type of uveitis, flare, and additional ocular procedures were identified and estimated using a mixed effect model with a backward selection procedure.
Results :
224 eyes from 166 patients were included. Mean age was 50.9 years (±19.6, 3-86) at initial uveitis diagnosis. 103 (62%) were female. 65 (39%) were Black, 60 (36%) White, 12 (14%) Hispanic, 7 (4%) Asian, and 11 (7%) Other. 144 eyes (64%) had anterior uveitis, 13 (6%) had anterior and intermediate uveitis, 17 (8%) had posterior uveitis, 39 (17%) had panuveitis, and 11 (5%) had scleritis. At baseline, BCVA was 0.64 logMAR (±0.69), 62 eyes (28%) had glaucoma, 40 (18%) had retinal diseases. 77 of 215 eyes reported flare (36%). Panuveitis had the worst BCVA compared to other uveitis types (P<0.001) at months 6, 12 and 24. At month 6, Asian and Black races had worse BCVA by 0.60 logMAR (±0.23, P=0.012) and 0.50 (±0.11, P<0.001), respectively, compared to White. BCVA was continuously worse in Black race compared to White by 0.37 logMAR (±0.11, P=0.001) and 0.40 logMAR (±0.12, P=0.001) for month 12 and month 24, respectively. Eyes without retinal disease had better BCVA at month 6 (P=0.025) and month 24 (P=0.009) by 0.28 logMAR (±0.12) and 0.36 logMAR (±0.14), respectively. BCVA at 12 months was affected by number of ocular procedures performed (0.13 logMAR (±0.05) per procedure (P=0.012).
Conclusions :
Panuveitis and eyes with history of retinal disease had worst visual outcomes. Black race, compared to White, Hispanic, and Other is associated with the worst BCVA in all forms of uveitis in 6, 12, and 24 months follow up visits. Flare did not significantly affect BCVA.
This is a 2021 ARVO Annual Meeting abstract.