Incidence rates and risk factors for ocular complications and vision loss in HLA-B27-associated uveitis

Allison Loh, Nisha R. Acharya

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Purpose: To calculate the incidence rates of ocular complications and vision loss in HLA-B27-associated uveitis and to explore the effect of chronic inflammation on clinical outcomes. Design: Retrospective longitudinal cohort study. Methods: The clinical records of 99 patients (148 uveitis-affected eyes) with HLA-B27-associated uveitis seen at a tertiary care center were included. The main outcome measures were ocular complications (posterior iris synechiae, band keratopathy, posterior subcapsular [PSC] cataracts, ocular hypertension, hypotony, cystoid macular edema, and epiretinal membrane) and vision loss. Anterior chamber inflammation was defined as 3 months after reviewing the patient's entire clinical course. Results: The clinical course was most commonly acute/recurrent (75%) or chronic (20%). The most common complications to develop during follow-up were ocular hypertension (0.10/eye-year) and PSC cataracts (0.09/eye-year). In multivariate analysis, the presence of posterior synechiae at presentation, inflammation, corticosteroid-sparing therapy, corticosteroid injections, chronic disease, and male gender were associated with a statistically significant increased risk of developing vision loss (20/50 or worse). Chronic disease course was associated with a 7-fold increased risk of visual impairment (hazard ratio [HR] = 6.8, P <.0001). The presence of inflammation during follow-up was associated with an increased risk of developing visual impairment (HR = 6.2, P <.0001). In multivariate analysis, chronic disease course and topical corticosteroids were associated with an increased risk of developing any incident ocular complication (HR = 2.2, P = .04 and HR = 3.3, P = .01, respectively). Conclusions: Poorly controlled inflammation was associated with the development of ocular complications including vision loss. Patients with chronic inflammation were also at greater risk of complications.

Original languageEnglish (US)
JournalAmerican Journal of Ophthalmology
Volume150
Issue number4
DOIs
StatePublished - Oct 2010
Externally publishedYes

Fingerprint

HLA-B27 Antigen
Uveitis
Inflammation
Incidence
Ocular Hypertension
Adrenal Cortex Hormones
Chronic Disease
Vision Disorders
Cataract
Ocular Hypotension
Multivariate Analysis
Epiretinal Membrane
Macular Edema
Anterior Chamber
Iris
Tertiary Care Centers
Longitudinal Studies
Cohort Studies
Outcome Assessment (Health Care)
Injections

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Incidence rates and risk factors for ocular complications and vision loss in HLA-B27-associated uveitis. / Loh, Allison; Acharya, Nisha R.

In: American Journal of Ophthalmology, Vol. 150, No. 4, 10.2010.

Research output: Contribution to journalArticle

@article{d8bae39d0aab4cf4bd6932539e968f82,
title = "Incidence rates and risk factors for ocular complications and vision loss in HLA-B27-associated uveitis",
abstract = "Purpose: To calculate the incidence rates of ocular complications and vision loss in HLA-B27-associated uveitis and to explore the effect of chronic inflammation on clinical outcomes. Design: Retrospective longitudinal cohort study. Methods: The clinical records of 99 patients (148 uveitis-affected eyes) with HLA-B27-associated uveitis seen at a tertiary care center were included. The main outcome measures were ocular complications (posterior iris synechiae, band keratopathy, posterior subcapsular [PSC] cataracts, ocular hypertension, hypotony, cystoid macular edema, and epiretinal membrane) and vision loss. Anterior chamber inflammation was defined as 3 months after reviewing the patient's entire clinical course. Results: The clinical course was most commonly acute/recurrent (75{\%}) or chronic (20{\%}). The most common complications to develop during follow-up were ocular hypertension (0.10/eye-year) and PSC cataracts (0.09/eye-year). In multivariate analysis, the presence of posterior synechiae at presentation, inflammation, corticosteroid-sparing therapy, corticosteroid injections, chronic disease, and male gender were associated with a statistically significant increased risk of developing vision loss (20/50 or worse). Chronic disease course was associated with a 7-fold increased risk of visual impairment (hazard ratio [HR] = 6.8, P <.0001). The presence of inflammation during follow-up was associated with an increased risk of developing visual impairment (HR = 6.2, P <.0001). In multivariate analysis, chronic disease course and topical corticosteroids were associated with an increased risk of developing any incident ocular complication (HR = 2.2, P = .04 and HR = 3.3, P = .01, respectively). Conclusions: Poorly controlled inflammation was associated with the development of ocular complications including vision loss. Patients with chronic inflammation were also at greater risk of complications.",
author = "Allison Loh and Acharya, {Nisha R.}",
year = "2010",
month = "10",
doi = "10.1016/j.ajo.2010.04.031",
language = "English (US)",
volume = "150",
journal = "American Journal of Ophthalmology",
issn = "0002-9394",
publisher = "Elsevier USA",
number = "4",

}

TY - JOUR

T1 - Incidence rates and risk factors for ocular complications and vision loss in HLA-B27-associated uveitis

AU - Loh, Allison

AU - Acharya, Nisha R.

PY - 2010/10

Y1 - 2010/10

N2 - Purpose: To calculate the incidence rates of ocular complications and vision loss in HLA-B27-associated uveitis and to explore the effect of chronic inflammation on clinical outcomes. Design: Retrospective longitudinal cohort study. Methods: The clinical records of 99 patients (148 uveitis-affected eyes) with HLA-B27-associated uveitis seen at a tertiary care center were included. The main outcome measures were ocular complications (posterior iris synechiae, band keratopathy, posterior subcapsular [PSC] cataracts, ocular hypertension, hypotony, cystoid macular edema, and epiretinal membrane) and vision loss. Anterior chamber inflammation was defined as 3 months after reviewing the patient's entire clinical course. Results: The clinical course was most commonly acute/recurrent (75%) or chronic (20%). The most common complications to develop during follow-up were ocular hypertension (0.10/eye-year) and PSC cataracts (0.09/eye-year). In multivariate analysis, the presence of posterior synechiae at presentation, inflammation, corticosteroid-sparing therapy, corticosteroid injections, chronic disease, and male gender were associated with a statistically significant increased risk of developing vision loss (20/50 or worse). Chronic disease course was associated with a 7-fold increased risk of visual impairment (hazard ratio [HR] = 6.8, P <.0001). The presence of inflammation during follow-up was associated with an increased risk of developing visual impairment (HR = 6.2, P <.0001). In multivariate analysis, chronic disease course and topical corticosteroids were associated with an increased risk of developing any incident ocular complication (HR = 2.2, P = .04 and HR = 3.3, P = .01, respectively). Conclusions: Poorly controlled inflammation was associated with the development of ocular complications including vision loss. Patients with chronic inflammation were also at greater risk of complications.

AB - Purpose: To calculate the incidence rates of ocular complications and vision loss in HLA-B27-associated uveitis and to explore the effect of chronic inflammation on clinical outcomes. Design: Retrospective longitudinal cohort study. Methods: The clinical records of 99 patients (148 uveitis-affected eyes) with HLA-B27-associated uveitis seen at a tertiary care center were included. The main outcome measures were ocular complications (posterior iris synechiae, band keratopathy, posterior subcapsular [PSC] cataracts, ocular hypertension, hypotony, cystoid macular edema, and epiretinal membrane) and vision loss. Anterior chamber inflammation was defined as 3 months after reviewing the patient's entire clinical course. Results: The clinical course was most commonly acute/recurrent (75%) or chronic (20%). The most common complications to develop during follow-up were ocular hypertension (0.10/eye-year) and PSC cataracts (0.09/eye-year). In multivariate analysis, the presence of posterior synechiae at presentation, inflammation, corticosteroid-sparing therapy, corticosteroid injections, chronic disease, and male gender were associated with a statistically significant increased risk of developing vision loss (20/50 or worse). Chronic disease course was associated with a 7-fold increased risk of visual impairment (hazard ratio [HR] = 6.8, P <.0001). The presence of inflammation during follow-up was associated with an increased risk of developing visual impairment (HR = 6.2, P <.0001). In multivariate analysis, chronic disease course and topical corticosteroids were associated with an increased risk of developing any incident ocular complication (HR = 2.2, P = .04 and HR = 3.3, P = .01, respectively). Conclusions: Poorly controlled inflammation was associated with the development of ocular complications including vision loss. Patients with chronic inflammation were also at greater risk of complications.

UR - http://www.scopus.com/inward/record.url?scp=77957285597&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77957285597&partnerID=8YFLogxK

U2 - 10.1016/j.ajo.2010.04.031

DO - 10.1016/j.ajo.2010.04.031

M3 - Article

VL - 150

JO - American Journal of Ophthalmology

JF - American Journal of Ophthalmology

SN - 0002-9394

IS - 4

ER -