Factors Predicting Visual Acuity Outcome in Intermediate, Posterior, and Panuveitis: The Multicenter Uveitis Steroid Treatment (MUST) Trial

John H. Kempen, Mark L. Van Natta, Michael M. Altaweel, James P. Dunn, Douglas A. Jabs, Susan L. Lightman, Jennifer E. Thorne, Janet T. Holbrook, Glenn J. Jaffe, Brenda Branchaud, Paul Hahn, Larry Koreen, Eleonora M. Lad, Phoebe Lin, Joseph Nissim Martel, Neha Serrano, Cindy Skalak, Lejla Vajzovic, Claxton Baer, Joyce BryantSai Chavala, Michael Cusick, Shelley Day, Pouya Dayani, Justis Ehlers, Muge Kesen, Annie Lee, Alex Melamud, Jawad A. Qureshi, Adrienne Williams Scott, Robert F. See, Robert K. Shuler, Megan Wood, Steven Yeh, Alcides Fernandes, Deborah Gibbs, Donna Leef, Daniel F. Martin, Sunil Srivastava, Hosne Begum, Jeff Boring, Kristen L. Brotherson, Bryn Burkholder, Nicholas J. Butler, Dennis Cain, Mary A. Cook, David Emmert, Janis R. Graul, Mark Herring, Ashley Laing, Theresa G. Leung, Michael C. Mahon, Ahmafreza Moradi, Antonia Nwankwo, Trucian L. Ostheimer, Terry Reed, Ellen Arnold, Patricia M. Barnabie, Marie Lynn Belair, Stephen G. Bolton, Joseph B. Brodine, Diane M. Brown, Lisa M. Brune, Anat Galor, Theresa Gan, Adam Jacobowitz, Meera Kapoor, Sanjay Kedhar, Stephen Kim, Henry A. Leder, Alison G. Livingston, Yavette Morton, Kisten Nolan, George B. Peters, Priscilla Soto, Ricardo Stevenson, Michelle Tarver-Carr, Yue Wang, C. Stephen Foster, Stephen D. Anesi, Linda Bruner, Olga Ceron, David M. Hinkle, Nancy Persons, Bailey Wentworth, Sarah Acevedo, Fahd Anzaar, Tom Cesca, Angelica Contero, Kayleigh Fitzpatrick, Faith Goronga, Jyothir Johnson, Karina Q. Lebron, Danielle Marvell, Chandra Morgan, Nita Patel, Jennifer Pinto, Sana S. Siddique, Janet Sprague, Taygan Yilmaz, H. Nida Sen, Michael Bono, Denise Cunningham, Darryl Hayes, Dessie Koutsandreas, Robert B. Nussenblatt, Patti R. Sherry, Gregory L. Short, Wendy Smith, Alana Temple, Allison Bamji, Hanna Coleman, Geetaniali Davuluri, Lisa Faia, Chloe Gottlieb, Guy V. Jirawuthiworavong, Julie C. Lew, Richard Mercer, Dominic Obiyor, Cheryl H. Perry, Natalia Potapova, Eric Weichel, Keith J. Wroblewski, Paul A. Latkany, Corinne Coonan, Andrea Honda, Monica Lorenzo-Latkany, Robert Masini, Susan Morell, Angela Nguyen, Jason Badamo, Kenneth M. Boyd, Matthew Enos, Jenny Gallardo, Jacek Jarczynski, Ji Yun Lee, Mirjana McGrosky, Ann Nour, Meredith Sanchez, Kate Steinberg, Richard J. Stawell, Lisa Breayley, Carly D'Sylva, Elizabeth Glatz, Lauren Hodgson, Lyndell Lim, Cecilia Ling, Rachel McIntosh, Julie Morrison, Andrew Newton, Sutha Sanmugasundram, Richard Smallwood, Ehud Zamir, Nicola Hunt, Lisa Jones, Ignatios Koukouras, Suzanne Williams, Pauline T. Merrill, Danielle Carns, Len Richine, Denise L. Voskuil-Marre, Kisung Woo, Bruce Gaynes, Christina Giannoulis, Pam Hulvey, Elaine Kernbauer, Heena S. Khan, Sarah J. Levine, Scott Toennessen, Eileen Tonner, Robert C. Wang, Hank Aguado, Sally Arceneaux, Karen Duignan, Gary E. Fish, Nick Hesse, Diana Jaramillo, Michael Mackens, Jean Arnwine, David Callanan, Kimberly Cummings, Keith Gray, Susie Howden, Karin Mutz, Brenda Sanchez, Filis Ismetova, Ashley Prytherch, Sophie Seguin-Greenstein, Oren Tomkins, Asat Bar, Kate Edwards, Lavanish Joshi, Jiten Moraji, Ahmed Samy, Timothy Stubbs, Simon Taylor, Hamish Towler, Rebecca Tronnberg, Gary N. Holland, Robert D. Almanzor, Jose Castellanos, Jean Pierre Hubschman, Ann K. Johiro, Alla Kukuyev, Ralph D. Levinson, Colin A. McCannel, Susan S. Ransome, Christine R. Gonzales, Anurag Gupta, Partho S. Kalyani, Michael A. Kapamajian, Peter J. Kappel, Cheryl Arcinue, Janne Chuang, Giulio Barteselli, Glenn Currie, Veronica Mendoza, Debbie Powell, Tom Clark, Denine E. Cochran, William R. Freeman, Joshua Hedaya, Tiara Kemper, Igor Kozak, Jacqueline M. Lemoine, Megan E. Loughran, Luzandra Magana, Francesca Mojana, Victoria Morrison, Vivian Nguyen, Stephen F. Oster, Nisha Acharya, David Clay, Salena Lee, Mary Lew, Todd P. Margolis, Jay Stewart, Ira G. Wong, Debra Brown, Claire M. Khouri, Debra A. Goldstein, Andrea Birnbaum, Andrea Degillio, Gemma De La Rosa, Carmen Ramirez, Evica Simjanowski, Mariner Skelly, Anna L. Castro-Malek, Catherine E. Crooke, Melody Huntley, Katrina Nash, Marcia Niec, Dimitry Pyatetsky, Misel Ramirez, Zuzanna Rozenbajgier, Howard H. Tessler, Janet L. Davis, Thomas A. Albini, Marie Chin, Daniela Castaño, Ariana Elizondo, Macy Ho, Jaclyn L. Kovach, Richard C.S. Lin, Efrem Mandelcorn, Jackie K.D. Nguyen, Aura Pacini, Susan Pineda, David A. Pinto, Jose Rebimbas, Kimberly E. Stepien, Claudia Teran, Susan G. Elner, Hillary Bernard, Linda Fournier, Lindsay Godsey, Linda Goings, Richard Hackel, Moella Hesselgrave, K. Thiran Jayasundera, Robert Prusak, Pamela Titus, Melissa Bergeron, Reneé Blosser, Rebecca Brown, Carrie Chrisman-Mcclure, Julie R. Gothrup, Stephen J. Saxe, Deanna Sizemore, James Berger, Sheri Drossner, Joan C. Dupont, Albert M. Maguire, Janice Petner, Stephanie Engelhard, Tim Hopkins, Jonathan Lo, Dawn McCall, Monique McRay, Rebecca Salvo, Daniel Will, Wei Xu, Elizabeth Windsor, Laurel Weeney, Peter R. Pavan, Ken Albritton, Joann Leto, Brian Madow, Lori Mayor, Scott E. Pautler, Wyatt Saxon, Judy Soto, Burton Goldstein, Amy Klukoff, Lucy Lambright, Kim McDonald, Maria Ortiz, Susan Scymanky, Dee Dee Szalay, Narsing Rao, Tamara Davis, Jackie Douglass, Judith Linton, Margaret Padilla, Sylvia Ramos, Narsing A. Rao, Alexia Aguirre, Lawrence Chong, Lupe Cisneros, Elizabeth Corona, Dean Eliott, Amani Fawzi, Jesse Garcia, Rahul Khurana, Jennifer Lim, Rachel Mead, Julie H. Tsai, Albert Vitale, Paul S. Bernstein, Bonnie Carlstrom, James Gilman, Sandra Hanseen, Paula Morris, Diana Ramirez, Kimberley Wegner, John D. Sheppard, Brianne Anthony, Amber Casper, Lisa Felix-Kent, Jeanette Fernandez, Tari Johnson, Stephen V. Scoper, R. Denise Cole, Nancy Crawford, Lisa Franklin, Krista Hamelin, Jen Martin, Rebecca Marx, Gregory Schultz, Joseph Webb, Pamela Yeager, Rosa Y. Kim, Matthew S. Benz, David M. Brown, Eric Chen, Richard H. Fish, Eric Kegley, Laura Shawver, Tien P. Wong, Rebecca De La Garza, Shayla Friday, P. Kumar Rao, Eve Adcock, Rajendra S. Apte, Amy Baladenski, Rhonda Curtis, Sarah Gould, Amanda Hebden, Jamie Kambarian, Charla Meyer, Sam Pistorius, Melanie Quinn, Greg Rathert, Kevin J. Blinder, Ashley Hartz, Pam Light, Gaurav K. Shah, Russell Vangelder, Natalie Kurinij, Nancy Prusakowski, Larry Hubbard, Janet Wittes, William E. Barlow, Marc Hochberg, Alice T. Lyon, Alan G. Palestine, Lee S. Simon, James T. Rosenbaum, Harmon Smith, Nisha R. Acharya, Jeffrey A. Boring, Judith Alexander, David S. Friedman, Anna Adler, Alyce Burke, Joanne Katz, Susan Reed, Husam Ansari, Nicholas Cohen, Sanjukta Modak, Wai Ping Ng, Elizabeth A. Sugar, Alyce E. Burke, Lea T. Drye, Kevin Frick, Thomas A. Louis, David Shade, Karen Pascual, Jill S. Slutsky-Sanon, Amanda Allen, Colby Glomp, Yasmin Hilal, Melissa A. Nieves, Maria Stevens, Francis Abreu, Anne Shanklin Casper, Cathleen Ewing, Adante Hart, Andrea Lears, Shirley Li, Jill Meinert, Vinnette Morrison, Deborah Nowakowski, Girlie Reyes, Dave M. Shade, Jacqueline Smith, Karen Steuernagle, Vidya Venugopal, Tsung Yu, Paul Chen, Karen Collins, John Dodge, Kevin D. Frick, Rosetta Jackson, Christian Jimenez, Ariel Landers, Hope Livingston, Curtis L. Meinert, Sobharani Rayapudi, Weijiang Shen, Charles Shiflett, Rochelle Smith, Ada Tieman, James A. Tonascia, Richard Zheng, James Allan, Wendy K. Benz, Amitha Domalpally, Kristine A. Johnson, Dawn J. Myers, Jeong Won Pak, James L. Reimers, Geoffrey Chambers, Debra J. Christianson, Margaret A. Fleischli, Jacquelyn Freund, Vonnie Gama, Sapna Gangaputra, Kathleen E. Glander, Anne Goulding, Dennis Hafford, Susan E. Harris, Larry D. Hubbard, Jeffrey M. Joyce, Christina N. Kruse, Lauren Nagle, Gwyn E. Padden-Lechten, Alyson Pohlman, Amy Remm, Ruth A. Shaw, Peggy Sivesind, Dennis Thayer, Erika Treichel, Kelly J. Warren, Sheila M. Watson, Mary K. Webster, James K. White, Tara Wilhelmson, Grace Zhang

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Purpose To identify factors associated with best-corrected visual acuity (BCVA) presentation and 2-year outcome in 479 intermediate, posterior, and panuveitic eyes. Design Cohort study using randomized controlled trial data. Methods Multicenter Uveitis Steroid Treatment (MUST) Trial masked BCVA measurements at baseline and at 2 years follow-up used gold-standard methods. Twenty-three clinical centers documented characteristics per protocol, which were evaluated as potential predictive factors for baseline BCVA and 2-year change in BCVA. Results Baseline factors significantly associated with reduced BCVA included age ≥50 vs <50 years; posterior vs intermediate uveitis; uveitis duration >10 vs <6 years; anterior chamber (AC) flare >grade 0; cataract; macular thickening; and exudative retinal detachment. Over 2 years, eyes better than 20/50 and 20/50 or worse at baseline improved, on average, by 1 letter (P =.52) and 10 letters (P <.001), respectively. Both treatment groups and all sites of uveitis improved similarly. Factors associated with improved BCVA included resolution of active AC cells, resolution of macular thickening, and cataract surgery in an initially cataractous eye. Factors associated with worsening BCVA included longer duration of uveitis (6-10 or >10 vs <6 years), incident AC flare, cataract at both baseline and follow-up, pseudophakia at baseline, persistence or incidence of vitreous haze, and incidence of macular thickening. Conclusions Intermediate, posterior, and panuveitis have a similarly favorable prognosis with both systemic and fluocinolone acetonide implant treatment. Eyes with more prolonged/severe inflammatory damage and/or inflammatory findings initially or during follow-up have a worse visual acuity prognosis. The results indicate the value of implementing best practices in managing inflammation.

Original languageEnglish (US)
Pages (from-to)1133-1141.e9
JournalAmerican journal of ophthalmology
Volume160
Issue number6
DOIs
StatePublished - Jan 1 2015

ASJC Scopus subject areas

  • Ophthalmology

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    Kempen, J. H., Van Natta, M. L., Altaweel, M. M., Dunn, J. P., Jabs, D. A., Lightman, S. L., Thorne, J. E., Holbrook, J. T., Jaffe, G. J., Branchaud, B., Hahn, P., Koreen, L., Lad, E. M., Lin, P., Martel, J. N., Serrano, N., Skalak, C., Vajzovic, L., Baer, C., ... Zhang, G. (2015). Factors Predicting Visual Acuity Outcome in Intermediate, Posterior, and Panuveitis: The Multicenter Uveitis Steroid Treatment (MUST) Trial. American journal of ophthalmology, 160(6), 1133-1141.e9. https://doi.org/10.1016/j.ajo.2015.09.017