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Factors predictive of remission of new-onset anterior uveitis.

Abstract：

PURPOSE:To identify factors predictive of remission of inflammation in new-onset anterior uveitis cases treated at tertiary uveitis care facilities. DESIGN:Retrospective cohort study. PARTICIPANTS:Patients seeking treatment at participating academic uveitis clinics within 90 days of initial diagnosis of anterior uveitis. METHODS:Retrospective cohort study based on standardized chart review. MAIN OUTCOME MEASURES:Factors predictive of remission (no disease activity without corticosteroid or immunosuppressive treatments at all visits during a 90-day period). RESULTS:Nine hundred ninety eyes (687 patients) had a first-ever diagnosis of anterior uveitis within 90 days before initial presentation and had follow-up visits thereafter. The median follow-up time was 160 days. Systemic diagnoses with juvenile idiopathic arthritis (JIA; adjusted hazard ratio [aHR], 0.38; 95% confidence interval [CI], 0.19-0.74) and Behçet's disease (aHR, 0.10; 95% CI, 0.01-0.85) were associated with a lower incidence of uveitis remission. Cases of bilateral uveitis (aHR, 0.68; 95% CI, 0.54-0.87) and those with a history of cataract surgery before presentation (aHR, 0.51; 95% CI, 0.29-0.87) also had a lower incidence of remission. Regarding clinical findings at the initial visit, a high degree of vitreous cells at initial presentation was associated with a lower incidence of remission (for 1+ or more vs. none: aHR, 0.72; 95% CI, 0.55-0.95). An initial visual acuity of 20/200 or worse, with respect to 20/40 or better, also was predictive of a lower incidence of remission (aHR, 0.52; 95% CI, 0.32-0.86). CONCLUSIONS:Factors associated with a lower incidence of remission among new-onset anterior uveitis cases included diagnosis with JIA, Behçet's disease, bilateral uveitis, history of cataract surgery, findings of 1+ or more vitreous cells at presentation, and an initial visual acuity of 20/200 or worse. Patients with these risk factors seem to be at higher risk of persistent inflammation; reciprocally, patients lacking these factors would be more likely to experience remission. Patients with risk factors for nonremission of uveitis should be managed taking into account the higher probability of a chronic inflammatory course.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Artornsombudh P,Pistilli M,Foster CS,Pujari SS,Gangaputra SS,Jabs DA,Levy-Clarke GA,Nussenblatt RB,Rosenbaum JT,Suhler EB,Thorne JE,Kempen JH

doi

10.1016/j.ophtha.2013.09.041

subject

Has Abstract

pub_date

2014-03-01 00:00:00

pages

778-84

issue

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(13)00886-5

journal_volume

121

pub_type

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Factors predictive of remission of new-onset anterior uveitis.