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Vision loss in anterior uveitis
  1. Haya H Al-Ani1,
  2. Joanne L Sims1,
  3. Oren Tomkins-Netzer2,
  4. Susan Lightman3,
  5. Rachael L Niederer1,4
  1. 1Ophthalmology, Greenlane Clinical Centre, Auckland, New Zealand
  2. 2Institute of Ophthalmology, University College London, London, UK
  3. 3Clinical Ophthalmology, Moorfields Eye Hospital, London, UK
  4. 4Department of Ophthalmology, University of Auckland, Auckland, New Zealand
  1. Correspondence to Dr Rachael L Niederer, Ophthalmology, Greenlane Clinical Centre, Auckland 1051, New Zealand; dr_rachnz{at}yahoo.co.nz

Abstract

Aims To evaluate the long-term risk of permanent vision loss in subjects with anterior uveitis.

Methods Retrospective study of subjects attending uveitis clinic at Auckland District Health Board and Moorfields Eye Hospital between 2008 and 2018. Main outcome measures were: best corrected visual acuity (BCVA); moderate vision loss (MVL ≤20/50); and severe vision loss (SVL ≤20/200).

Results 2526 eyes of 1814 subjects were included with a mean follow-up of 6.8 years (17 235.4 eye-years of follow-up). MVL occurred in 240 eyes (9.5%) during the follow-up period, of which 97 (3.8%) had permanent MVL due to uveitis. The incidence of permanent MVL due to uveitis was 0.006 per eye-year with a cumulative risk at 10 years of 6.6% (5.2%–8.4%). The most common cause of permanent MVL due to uveitis was uveitic glaucoma (31.3%), followed by cystoid macular oedema (27.1%) and corneal scar (21.9%). SVL occurred in 80 eyes (3.2%) during the follow-up period, of which 39 (1.5%) had permanent SVL due to uveitis. The incidence of permanent SVL due to uveitis was 0.002 per eye-year with a cumulative risk at 10 years of 2.6% (1.8%–3.7%). Multivariate analysis showed older age at presentation, chronic anterior uveitis (CAU), infectious aetiology and poor presenting BCVA were all risk factors for permanent MVL due to uveitis.

Conclusions Although vision loss is an uncommon complication in anterior uveitis, the risk is greatest in those with CAU, infectious aetiology and poor presenting BCVA. Uveitic glaucoma is the most common cause of vision loss.

  • inflammation
  • vision
  • glaucoma
  • infection
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Footnotes

  • Presented at Abstract submitted for presentation at RANZCO Conference 2019 in Sydney, Australia.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethics committee approval was obtained prior to data collection (Auckland ethics approval NTX/12/EXP/085, Moorfields ethics approval ROAD16039).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.

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