ABSTRACT

Purpose:

To report factors that predict visual loss in adults with uveitis. Also, to analyse the influence of baseline and newly diagnosed ocular complications during follow-up on visual outcome.

Methods:

Retrospective cohort study of 474 patients with uveitis (655 eyes) followed for at least one month attended between May 1989 and December 2012. Kaplan-Meier curves were set to analyze the change in best-corrected visual acuity (BCVA) in relation to development of ocular complications during follow-up. Cox’s bivariate and multivariate regression models were constructed to examine the risk factors for visual loss.

Results:

After a mean follow-up of 32 months (interquartile range 8-80), 48.4% of patients developed one or more complications, including cataract formation (26.5%), iris alterations (19.8%), and macular edema (16.5%) as the most frequent. Median logMAR (logarithm of the minimun angle of resolution) of the best-corrected visual acuity (BCVA) at presentation was 0.36 and 0.27 at last follow-up, Median of the BCVA was >20/50 in 78.3% of the observed eyes. Presenting complications statistically significantly affected logMAR VA (Visual acuity) (0,42 logMAR) at final follow-up, adversely affected in 1.7 lines ETDRS (Early treatment diabetic retinopathy study) (IC 95% 1,1;2,2; p<0,001) less than those without. On multivariate analysis, uveitis of viral ethiology (p<0,001) was associated with increased risk of losing two or more lines of ETDRS in final VA. Of all the complications diagnosed at presentation, only maculopathies (p=0,001) were found to be significantly linked to worse logMAR VA at last follow-up, Of those newly diagnosed, cataract (p=0,003), macular edema (p=0,007) and maculopathies (p=0,046) were independently associated with losing at least 2 lines of ETDRS in final VA.

Conclusion:

Worse visual prognosis was concomitant maculopathies at presentation. Some baseline characteristics could help us identifying those patients with a higher risk of losing visual acuity such as infectious uveitis of viral ethiology. Despite this, uveitis in adults seems to have a favourable long-term prognosis, and the most prevalent complications, cataract and macular edema, were associated with mild visual loss.


CONTACT DETAILS

 

Maria del Mar Prieto del Cura, J.J. Gonzalez-Guijarro
The University Hospital La Princesa
Madrid
Spain
Email : marprieto20@yahoo.com
Cell Phone: +34680847460
Work Phone: +34680847460