Abstract
Purpose :
To describe the presenting characteristics and management of inflammatory papillitis in adult patients with uveitis.
Methods :
Observational, retrospective cohort study of adult patients referred to a tertiary care uveitis practice from September 2021 to November 2022. Clinical characteristics of eyes presenting with inflammatory papillitis were compared to those without papillitis using appropriate descriptive statistics.
Results :
139 patients (215 eyes) were selected as new patients with active uveitis referred within the specified time frame. Average age was 50 years (range 18 to 89) and 65% were female. 56% presented with bilateral uveitis, and 29 eyes (13%) in 19 patients (14%) had papillitis at time of referral. In patients with papillitis, the most common etiologies were sarcoidosis (16%) and syphilis (11%); 10 patients (53%) were deemed idiopathic. The predominant etiologies in patients without papillitis were HLA-B27 (12%) and post-operative inflammation (10%); 53 patients (44%) were deemed idiopathic. Presenting visual acuity ranged broadly in both eyes with papillitis (20/20 to finger counting, average 20/40) and those without (20/15 to hand motion, average 20/30), but there was no significant difference in mean VA between the two groups (p=0.106). Eyes with papillitis featured posterior inflammation more commonly (24%) than those without papillitis (18%), though this difference was not statistically significant (p=0.245). Conversely, patients with papillitis featured anterior chamber inflammation less commonly (28%) than those without papillitis (36%), though the difference was not statistically significant (p=0.373). 62% of eyes with papillitis presented to uveitis specialty care on topical and/or oral steroids compared to 57% of eyes without (p=0.568), and 14% of eyes with papillitis presented on immunosuppressive therapy (IMT) compared to 20% of eyes without (p=0.435). After establishing care with a uveitis specialist, 86% of eyes with papillitis were prescribed topical and/or oral steroids compared to 73% without (p=0.131), and 24% of eyes with papillitis were prescribed IMT compared to 23% without (p=0.904).
Conclusions :
Presenting characteristics and management of adult patients with and without inflammatory papillitis may be similar. Most common etiologies of papillitis include syphilis and sarcoid, compared to HLA-B27 and post-operative inflammation in eyes without papillitis.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.