Intermediate Uveitis: Long-term Course and Visual Outcome

Abstract

Background: In this retrospective cohort study we investigated the long-term course and outcomes of intermediate uveitis (IU).

Methods: Institutional study of patients with IU with a follow-up of at least 10 years, followed at tertiary referral center.

Results: We had 29 patients with unilateral or bilateral IU. The average age at onset of IU was 31 years. At onset, 3 patients (17%) had associated systemic disease (2 sarcoidosis and 1 multiple sclerosis) and one patient had granuloma annulare. During the follow-up period, one additional patient was diagnosed with sarcoidosis and 1 with multiple sclerosis. The percentage of eyes with legal blindness and visual impairment gradually increased over time (from 9/53, 17% at onset to 15/53, 28% at 10 years follow-up, with macular edema, cataract, and vitreous opacities being the most common causes of vision loss. The presence of associated anterior uveitis was more frequently noted in patients younger than 20 at onset. Remissions of intraocular inflammation of at least one year were noted in 10/29 (34%) of patients. The mean time-to-remission was 8.6 years and the patients with remissions were younger at the onset of IU than those with ongoing active IU (P=0.036). Remissions of IU exhibited borderline association with the absence of systemic disease (P=0.046).

Conclusions: One-third of IU patients achieved a remission of their intraocular inflammation longer than one year and a mean time-to-remission of 6 years. Younger patients were more likely to achieve remission than older patients.