Follow-Up Study of Over Three Years of Patients with Uveitis after Cataract Phacoemulsification: Outcomes and Complications

Purpose: To evaluate the rate and onset of intraoperative and postoperative complications post-phacoemulsification. Methods: One hundred sixty-two eyes of 145 patients with uveitis who underwent phacoemulsification between 2006 and 2009 were identified through surgical record review. Fifty-nine eyes of 46 patients met the inclusion criteria. Hazard ratio (HR) and Kaplan-Meier survival probability were calculated for each class of uveitis. Results: Macular edema (ME) resulted to be associated to chronic postoperative inflammation (r?=?0.6; p?=?0.00) and mostly related to patients who presented more than one postoperative relapse/year (r?=?0.2; p?=?0.02). Fuchs uveitis resulted to be a risk factor for posterior capsule opacification (PCO) (HR 3.36 IC95%1.0-10.5; p?=?0.03). Hypotony and elevated intraocular pressure (IOP) were detected in the anterior uveitis group (0.02 EY). Conclusion: The HR to develop ME was significantly related to chronic anterior uveitis. PCO and elevated IOP are most frequent in Fuchs uveitis. The postoperative visual acuity result was good among all the uveitis groups.     

Visual Prognosis and Ocular Complications in Herpetic versus HLA-B27- or Ankylosing Spondylitis-associated Anterior Uveitis

Purpose: To investigate the visual prognosis and ocular complications in patients with herpetic versus HLA-B27 associated anterior uveitis (AU).

Methods: This was a retrospective, observational study conducted at the ophthalmology department of the University Medical Center of Groningen. Sixty-two herpetic and 113 HLA-B27-associated AU patients were included. The main outcome measures were visual acuity and ocular complications.

Results: Visual acuity over time was significantly lower in herpetic as compared to HLA-B27 AU, mainly due to corneal scarring. The incidence rate of any ocular complication was higher in herpetic AU compared to HLA-B27-associated AU (0.140/EY versus 0.076/EY, p?=?<0.001), which was mainly due to glaucoma (0.033/EY versus 0.004/EY, p?p?Conclusions: The most prominent finding was a worse visual prognosis in herpetic AU, which is probably related to higher prevalence of corneal scarring and glaucoma. In addition, herpetic AU patients have more ocular complications overall.     

American Uveitis Society Winter Symposium,January 1997

Abstract

Purpose: To investigate the association between smoking and prognosis of ocular Behçet disease.

Material/Methods: Medical records of 202 patients with Behçet uveitis were collected retrospectively. Patients were assigned to two groups according to smoking habits. In group I, 72 patients were current smokers. In group II, 130 were nonsmokers. The localization of uveitis, time to resolution of uveitis, time to recurrences, visual acuities, and presence of cystoid macular edema were compared between groups.

Results: The demographic characteristics were similar in both groups. Smoking was not associated with types of uveitis with OR of 1.01 (95% CI, 0.99–1.04; p?=?0.21) for anterior uveitis, 0.96 (95%CI, 0.90–1.02; p?=?0.18) for posterior uveitis, and 1.80 (95% CI, 0.75–2.77; p?=?0.24) for panuveitis. The average times to inflammation resolution were 48?±?10.1 days in group I and 51?±?14 days in group II (p?=?0.82). The average times to recurrence were 8.6?±?5 months for smokers and 9.1?±?7 months for nonsmokers (p?=?0.43). Patients with CME in groups were 18 (25%) and 42 (32.3%), respectively (p?=?0.08).

Conclusions: Our findings suggest that smoking does not have a negative effect on the clinical findings and prognosis of uveitis in Behçet disease.     

Social Determinants and Their Impact on Visual Impairment in Southern Mexico

Abstract

Purpose: Visual impairment in disadvantaged populations in Mexico has been scarcely reported. We compared the prevalence of visual impairment and its associated risk factors in populations in rural compared to urban areas of the Mexican southern state of Chiapas.

Methods: In a population-based study, the prevalence of visual impairment in rural and urban areas of Comitan, Chiapas, was estimated. All eligible individuals aged ≥20 years living in rural areas were invited to participate; persons from urban areas were chosen randomly. Individuals were considered of indigenous (IND) origin either by self-report or if they spoke an IND language. Visual acuity (VA) and pinhole VA were measured using a tumbling E chart. VA was defined as normal (better than or equal to 20/60), moderate impairment (worse than 20/60 but better than or equal to 20/200), severe impairment (worse than 20/200 but better than or equal to 20/400), or blindness (worse than 20/400).

Results: Data on VA were obtained from 969 persons (610 rural, 359 urban) whose mean age was 43.3 years (standard deviation 15.6 years). Prevalence of moderate visual impairment was higher in rural (10.2%, 95% confidence interval, CI, 7.2–14.2%) than urban (3.9%, 95% CI 1.9–7.9%) areas (p?<?0.001). Persons with moderate visual impairment were older and less educated (both p?<?0.001). Rural individuals aged 50 years and older had 4.4 times (95% CI 1.8–11.3, p?=?0.002) the likelihood of having moderate visual impairment compared with urban persons.

Conclusion: Unfavorable socioeconomic conditions were associated with higher prevalence of moderate visual impairment in rural compared with urban populations in Mexico.     

Prognostic factors in Vogt-Koyanagi-Harada disease

Purpose To identify prognostic factors for final visual outcome, development of complications, and recurrent inflammation in patients with Vogt-Koyanagi-Harada (VKH) disease. Methods All patients diagnosed with acute uveitis associated with VKH disease at the King Khaled Eye Specialist Hospital and King Abdulaziz University Hospital between January 1999 and February 2004 were reviewed. Data collected included age, gender, initial and final visual acuities, clinical findings at presentation, interval between onset of disease and starting treatment, treatment received, complications, number of recurrences, extraocular manifestations, and duration of follow-up period. Results Sixty-eight patients were identified. There were 51 (75%) females and 17 (25%) males with a mean age of 25.04 ± 10.28 years (range 7–55 years). The mean follow-up period was 34.4 ± 20.1 months (range 8–62 months). The following factors were significantly associated with final visual acuity of 20/20 by univariate analysis: good initial visual acuity of better than 20/200 (p = 0.0415), absence of posterior synechiae of the iris at presentation (p = 0.0106), use of systemic corticosteroids for longer than nine months (p = 0.0479), slow tapering of systemic corticosteroids (p = 0.0024), absence of complications (p < 0.001), and absence of extraocular manifestations (p = 0.0124). Logistic regression analysis identified the use of systemic corticosteroids for longer than nine months to be associated with final visual acuity of 20/20 [odds ratio = 3.4; 95% confidence interval (CI) = 1.14–10.1]. The following factors were significantly associated with the development of complications by univariate analysis: age older than 18 years (p = 0.0161), initial visual acuity of 20/200 or worse (p = 0.0011), and presence of posterior synechiae of the iris at presentation (p = 0.0453). Factors identified after logistic regression analyses were age older than 18 years (odds ratio = 3.3; 95% CI = 1.33–8.17), and presence of posterior synechiae of the iris at presentation (odds ratio = 3.42; 9% CI = 1.38–8.47). Initial visual acuity of better than 20/200 was significantly associated with a lower risk of developing complications (odds ratio = 0.283; 95% CI = 0.129–0.629). The following factors were significantly associated with recurrent inflammation of three times or more by univariate analysis: initial visual acuity of 20/200 or worse (p = 0.0179), anterior chamber reaction of more than 2+ at presentation (p < 0.001), rapid tapering of systemic corticosteroids (p < 0.001), and development of extraocular manifestations (p = 0.0277). Conclusions Clinical findings at presentation, duration and method of tapering of systemic corticosteroids, and development of extraocular manifestations are significantly associated with final visual acuity, development of ocular complications, and recurrent inflammation. The development of ocular complications was significantly associated with a worse final visual acuity.     

Juvenile Idiopathic Arthritis Associated Uveitis in Adults: A Case Series

Purpose: To report a series of adults with uveitis following juvenile idiopathic arthritis (JIA) and uveitis as children.

Methods: The clinical features, treatment, complications, and visual outcome were ascertained for 17 patients at a single centre.

Results: Seventeen adults with previously diagnosed JIA and ongoing uveitis (30 eyes) were identified. All required at least topical steroids. The complication rate was high (15 patients, 23 eyes), most frequently cataract (57%), glaucoma (33%), and posterior synechiae (30%). The rate of visual acuity loss to 6/12 threshold (6/12 or worse) for patients with uveitis?<?15 years (Group A) was 13.3%, (and 6.7% to 6/60 threshold) and for patients with uveitis >15 years (Group B) was 26.7% (and 20% to 6/60 threshold). Overall, the rate of visual acuity loss to 6/12 threshold was 20% (6 eyes) and to 6/60 threshold, 13.3% (4 eyes).

Conclusions: JIA may be associated with ongoing uveitis and complications in adulthood.     

Clinical Manifestations and Outcomes of Syphilis-associated Uveitis in Northern Spain

Purpose: To describe the clinical characteristics and to assess visual prognosis of patients with syphilis-associated uveitis in northern Spain.

Methods: Retrospective review of clinical records in eight general uveitis referral centers.

Results: Since the year 2000, 50 patients have been diagnosed: 31 men and 19 women; median age was 41 (19–76) years. A total of 34% were co-infected with HIV and 24% presented systemic manifestations of syphilis. Median initial visual acuity and vision at last visit in 93 affected eyes was 20/50 (20/20–20/2000) and 20/22 (20/20–20/2000), respectively (p?p?=?0.009).

Conclusions: In our series, patients with syphilitic uveitis were more usually middle-aged men and were frequently co-infected with HIV. Although most patients showed posterior segment involvement, visual prognosis was good.     

Extended Oligoarthritis and Other Risk Factors for Developing JIA-Associated Uveitis Under ILAR Classification and Its Implication for Current Screening Guideline

Purpose: To investigate the risk factors for developing uveitis in a regional cohort of patients with juvenile idiopathic arthritis (JIA) as classified under ILAR criteria. Patients and Methods: The clinical factors for developing uveitis and its visual outcome were studied retrospectively for all children diagnosed with JIA at Nottingham University Hospital, England from 1974 to 2001. Results: A total of 202 patients with juvenile idiopathic arthritis were identified. Twenty-three patients (11.4%) were found to have uveitis. The mean age of arthritis onset in those with uveitis was 4.9 (95% CI 3.4–6.4) and in those without uveitis was 7.6 (95% CI 7.0–8.3), p = 0.002. Both the persistent and extended oligoarthritis groups are at significant risk of developing uveitis on Kaplan-Meier analysis with p = 0.001 and 0.013, respectively, compared to other ILAR subtypes. Extended oligoarthritis (1 to 4 joints affected in first 6 months of disease but 5 or more cumulative joints after first 6 months) had the highest prevalence of uveitis (25%) among the ILAR subtypes. Patients with extended oligoarthritis also developed uveitis earlier than persistent group, p = 0.017. Gender, race, and antinuclear antibody (ANA) status were not significant risk factors. The visual outcome was favorable, with 90% achieving acuity of 6/12 or better. Conclusion: Patients with extended oligoarthritis are at higher risk and have a shorter interval from diagnosis of arthritis to development of uveitis and need to be monitored more closely. Screening guideline for JIA-associated uveitis based on ILAR classification is called for.     

Causes of Visual Loss Associated with Uveitis in a Singapore Tertiary Eye Center

Purpose: To identify the causes of visual loss associated with uveitis and its risk factors.

Methods: Review of 359 patients attending a uveitis service.

Results: Anterior uveitis (n?=?229, 63.8%) was most common, followed by panuveitis (n?=?55, 15.3%). There were 82 infective cases with 29.3% associated with tuberculosis. Visual loss occurred in 100 (27.9%) patients, of which 27 (7.5%) had severe visual loss. The main causes of visual loss were cataract (26%) and glaucoma (12%). Cystoid macular edema (14.8%) accounted for severe visual loss. Panuveitis was predictive for visual loss (p?=?0.022, odds ratio (OR) 2.22) and severe visual loss (p?=?0.01, OR 3.47). Posterior uveitis (p?=?0.005, OR 5.01) and chronic uveitis (p?=?0.008, OR 3.83) also showed higher risk for severe visual loss.

Conclusion: With panuveitis being the second most common presentation, early specialist referral is essential in preventing visual loss.     

Risk factors for ocular complications and poor visual acuity at presentation among patients with uveitis associated with juvenile idiopathic arthritis

PURPOSE: To describe the frequencies of and risk factors for ocular complications and poor visual acuity at presentation in a cohort of patients with juvenile idiopathic arthritis (JIA)-associated uveitis. DESIGN: Cross-sectional study. METHODS: setting: Single-center, academic practice. study population: Seventy-five patients with JIA-associated uveitis were evaluated between July 1984 and August 2005. observation procedures: Data on patients diagnosed with JIA-associated uveitis were entered retrospectively into a database and analyzed. outcome measures: Visual acuity of 20/50 or worse or 20/200 or worse, and presence of ocular complications (including cataract, posterior synechiae, band keratopathy, elevated intraocular pressure, hypotony, macular edema, and epiretinal membrane) at presentation. RESULTS: At presentation, ocular complications were seen in 67% of eyes affected by JIA-associated uveitis. Presence of > or =1+ anterior chamber flare, a positive antinuclear antibody (ANA), and a shorter duration between the diagnosis of arthritis and uveitis were significantly associated with the presence of ocular complication. The frequencies of 20/50 or worse and of 20/200 or worse visual acuities at presentation in affected eyes were 36% and 24%, respectively. The presence of > or =1+ anterior chamber flare and a history of intraocular surgery before presentation were significantly associated with 20/50 or worse and 20/200 or worse vision. Presence of posterior synechiae also was associated with 20/200 or worse vision at presentation. The main causes of poor vision at presentation for affected eyes and better-seeing eyes were cataract, band keratopathy within the visual axis, and glaucoma. CONCLUSIONS: Ocular complications and poor vision at presentation were common in our patients with JIA-related uveitis.     

Outcomes and Projected Impact on Vision Restoration of the China Million Cataract Surgeries Program

Abstract

Purpose: The recently completed Chinese “Million Cataract Surgeries Program” (MCSP) is among the largest such campaigns ever, providing 1.05 million operations. We report MCSP outcomes for the first time, in Jiangxi, the province with the greatest program output.

Methods: Ten county hospitals participating in MCSP were selected in Jiangxi (range of gross domestic product per capita US$743–2998). Each hospital sought to enroll 75 consecutive MCSP patients aged ≥50 years. Data recorded included type of cataract procedure, bilateral uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), and refractive error pre- and ≥50 days postoperatively.

Results: Among 715 patients (mean age 72.3?±?9.1 years, 55.5% female), preoperative UCVA was <3/60 (legally blind) bilaterally in 13.3% and unilaterally in the operated eye in 50.9%. No subjects had UCVA >6/18 preoperatively. Small incision cataract surgery was performed in 92.3% patients. Among 662 patients (92.6%) completing follow-up was ≥ 40 days after surgery, BCVA was ≥6/18 in 80.1%, UCVA was ≥6/18 in 57.1% and UCVA was <3/60 in 2.1%. Older age (p?<?0.001), female sex (p?=?0.04), worse refractive error (p?=?0.02) and presence of intra- (p?=?0.002) and postoperative surgical complications (p?<?0.001), were independently associated with worse postoperative UCVA. Based on these results, the MCSP cured an estimated 124,950 cases (13.3%?×?[100?2.1%]?×?1.05 million) of bilateral and 502,500 (50.9%?×?[100?2.1%]?×?1.05 million) of unilateral blindness.

Conclusions: Due to relatively good outcomes and the large number of surgeries performed on blind persons, the sight-restoring impact of the MCSP was probably substantial.     

Association of Lysyl oxidase (LOX) Polymorphisms with the Risk of Keratoconus in an Iranian Population

Background: Keratoconus is a connective tissue-related eye disease with unknown etiology that causes the loss of visual acuity. Lysyl oxidase (LOX) is an amine oxidase that catalyzes the covalent cross-link of collagens and elastin in the extracellular environment, thus determining the mechanical properties of connective tissue. The current study aimed to investigate the possible associations between two LOX polymorphisms, rs1800449 and rs2288393, and susceptibility to keratoconus.

Methods: A total of 262 Iranian subjects including 112 patients with keratoconus and 150 healthy individuals as controls were recruited. Genotyping for the LOX variants was performed using allele-specific PCR.

Results: A significant difference was found between two groups regarding allelic and genotyping distribution of LOX polymorphism at position rs1800449 G>A. The frequency of AA and GA?+?AA genotypes were increased in patients compared to controls (17% versus 8% and 62.5% versus 50%, respectively), showing a statistically significant difference (OR?=?2.827, 95% CI: 1.251–6.391, p?=?0.012). The A allele was associated with an increased risk for keratoconus, with the frequency of 39.9% and 29% in patients and controls, respectively (OR?=?1.614, 95% CI: 1.119–2.326, p?=?0.011). Furthermore, the haplotype analysis revealed that the rs1800449G/rs2288393C is a protective factor against keratoconus (OR?=?0.425, 95% CI?=?0.296–0.609, p?=?0.001). Conversely, the +473A/rs2288393C (OR?=?3.703, 95% CI?=?2.230–6.149, p?=?0.001) and +473G/rs2288393G (OR?=?15.48, 95% CI?=?3.805–63.03, p?=?0.001) haplotypes were identified as risk factors for keratoconus.

Conclusion: Our study demonstrated that the LOX rs1800449 genotypes (AA and GA?+?AA) and allele (A) appears to confer risk for susceptibility to keratoconus.     

Optic Neuropathy among a Prison Population in Papua New Guinea

ABSTRACT

Purpose: To estimate the prevalence of optic neuropathy (ON) among prisoners in a provincial prison in Papua New Guinea, and to explore risk factors for this condition among this population.

Methods: Cross-sectional observation study of 148 male prisoners aged ≥18 years using an interview-based questionnaire, assessment of visual and nervous system function, ocular examination, and blood analysis (α-tocopherol, β-carotene, lutein, folate, homocysteine, holotranscobalamin II, riboflavin, selenium, thiamin, and vitamins A, B₁₂ and C). Likelihood of the presence of ON was based on ordered groups determined by weighted combination of optic nerve head appearance and visual dysfunction (acuity, field, color perception). Main outcome measures were prevalence and associations of ON.

Results: Sample prevalence of clinical ON was 10.4% (95% confidence interval [CI], 6.2–16.8). No cases were found of unexplained non-visual nervous system dysfunction, including peripheral neuropathy. Increasing age (p?=?0.001), length of current (p?=?0.002) and lifetime (p?=?0.03) incarceration, and duration of smoking by current smokers (p?=?0.001) were associated with increased ON likelihood. However, when age-controlled, the smoking duration association was not maintained (p?=?0.6). Prisoners were folate deficient. Adjusting for age and duration of current incarceration, whole blood (p?=?0.02) and red blood cell (p?=?0.04) folate concentrations were inversely associated with ON likelihood. No association was found for any other assessed demographic, lifestyle or biochemical measure.

Conclusions: A cluster of ON associated with folate deficiency has been identified. Recommendations for dietary change and micronutrient supplementation have been made.     

Vision-related Quality of Life in Patients with Non-infectious Uveitis: A Cross-sectional Study

Purpose: To analyze the influence of socio-demographic, comorbidity, and clinical-related variables in the vision-related quality of life (VR-QoL) of non-infectious uveitis patients.

Methods: Cross-sectional study includes 156 consecutive non-infectious uveitis patients from a tertiary uveitis clinic from Madrid (Spain). The main outcome was the log-transformed composite score of the Visual Functioning Questionnaire 25. Bivariate and multivariate ordinary least-squares regression models were performed and results expressed using effect sizes with 95% confidence intervals (95% CI).

Results: In the multivariate analysis, one unit increase in the logarithm of the minimum angle of resolution scale [i.e., worse best corrected visual acuity (BCVA)] was associated with a seven times worse VR-QoL (a 0.14-fold change [95% CI: 0.07–0.27]). Patients with ocular comorbidities had a 64% worse VR-QoL (a 0.61-fold change [95% CI: 0.49–0.77]).

Conclusions: Lower BCVA and the presence of ocular comorbidities had a significant, independent, and deleterious effect in the VR-QoL of non-infectious uveitis patients.     

Prevalence of Visual Impairment and Uncorrected Refractive Error – Report from a Canadian Urban Population-based Study

Abstract

Purpose: The prevalence of visual impairment due to uncorrected refractive error has not been previously studied in Canada. A population-based study was conducted in Brantford, Ontario.

Methods: The target population included all people 40 years of age and older. Study participants were selected using a randomized sampling strategy based on postal codes. Presenting distance and near visual acuities were measured with habitual spectacle correction, if any, in place. Best corrected visual acuities were determined for all participants who had a presenting distance visual acuity of less than 20/25.

Results: Population weighted prevalence of distance visual impairment (visual acuity <20/40 in the better eye) was 2.7% (n?=?768, 95% confidence interval (CI) 1.8–4.0%) with 71.8% correctable by refraction. Population weighted prevalence of near visual impairment (visual acuity <20/40 with both eyes) was 2.2% (95% CI 1.4–3.6) with 69.1% correctable by refraction. Multivariable adjusted analysis showed that the odds of having distance visual impairment was independently associated with increased age (odds ratio, OR, 3.56, 95% CI 1.22–10.35; ≥65 years compared to those 39–64 years), and time since last eye examination (OR 4.93, 95% CI 1.19–20.32; ≥5 years compared to ≤2 years). The same factors appear to be associated with increased prevalence of near visual impairment but were not statistically significant.

Conclusions: The majority of visual impairment found in Brantford was due to uncorrected refractive error. Factors that increased the prevalence of visual impairment were the same for distance and near visual acuity measurements.     

Recurrence of Uveitis after Discontinuation of Infliximab

Abstract

Purpose: To evaluate the recurrence of uveitis after discontinuation of infliximab once control of inflammation is achieved.

Methods: A retrospective cohort study was conducted of patients seen at the Proctor Foundation between 1998 and 2010 who discontinued infliximab after achieving corticosteroid-sparing control by Standardization of Uveitis Nomenclature criteria. The main outcome was the proportion of patients who had a relapse of uveitis.

Results: Eighteen patients attempted to discontinue infliximab after achieving control of inflammation, and 11 patients had a relapse. Median time to relapse was 603 days (95% CI: 85–1461 days). Patients with juvenile idiopathic arthritis (JIA)-associated uveitis (n?=?4) relapsed faster (median time to relapse: 76 days, p?=?0.002) compared with patients who did not have JIA-associated uveitis (median?=?1169 days).

Conclusions: The majority of patients who achieved control of inflammation on infliximab had a recurrence after discontinuing therapy. Patients with JIA experienced recurrence faster compared to other patients.     

Juvenile idiopathic arthritis-associated uveitis: incidence of ocular complications and visual acuity loss

PURPOSE: To estimate the incidences of ocular complications and vision loss in patients with juvenile idiopathic arthritis (JIA)-associated uveitis, to describe risk factors for vision loss, and to describe the association between therapy and complications and vision loss. DESIGN: Retrospective cohort study. METHODS: setting: Single-center, academic practice. study population: A total of 75 patients with JIA-associated uveitis evaluated between July 1984 and August 2005. procedures: Clinical data on these patients were analyzed. outcome measures: Occurrence of ocular complications and visions of 20/50 or worse and 20/200 or worse. RESULTS: Over a median follow-up of three years, the incidence of any ocular complication was 0.33/eye-year (EY). Rates of vision loss to 20/50 or worse and 20/200 or worse were 0.10/EY and 0.08/EY, respectively. Risk factors at presentation for incident vision loss included presence of posterior synechiae, anterior chamber flare > or = 1+, and abnormal intraocular pressure (IOP). During follow-up, ocular inflammation > or = 0.5+ cells was associated with an increased risk of visual impairment (relative risk [RR] = 2.02, P = .006) and of blindness (RR = 2.99, P = .03). Immunosuppressive drug therapy reduced the risk of hypotony by 74% (P = .002), epiretinal membrane formation by 86% (P = .05), and blindness in the better eye by 60% (P = .04). CONCLUSIONS: Incident vision loss and complications were common. Presence of posterior synechiae, anterior chamber flare > or = 1+, and abnormal IOP at presentation were associated with vision loss during follow-up. Use of immunosuppressive drugs reduced the risk of some ocular complications and of blindness in the better-seeing eye.     

Antituberculous Treatment Itself Might Prevent Visual Impairment in Presumed Tuberculosis-Related Uveitis

ABSTRACT

Purpose: To study the risk factors for visual loss in presumed tuberculosis-related uveitis (TRU).

Methods: Retrospective observational cohort study of patients with TRU, either treated or not for tuberculosis, from January 2005 to January 2017. Clinical and demographic variables were recorded. Main outcome measure was a loss of visual acuity (VA) of ≥2 Snellen lines. A Generalized Estimation Equation was used to control between-eyes bias. A backward stepwise logistic regression multivariate analysis was conducted to elucidate independent risk factors.

Results: One hundred and thirty-eight eyes from 82 patients were included. There were 45 males, median age at onset of uveitis was 40 years (Interquartile range, IQR 24). The median follow-up was 36 months (IQR 49.75) and 51 patients completed antituberculous treatment (ATT) for a mean of 9.37 months. In the multivariate model, ATT was the only independent protective factor for loss of VA (OR 0.13, 95% CI 0.04–0.37, p < 0.001).

Conclusion: ATT itself may prevent visual loss in TRU.     

Patterns of cytomegalovirus retinitis at a tertiary referral center in Turkey

Purpose

To analyze predisposing conditions in Turkish patients with CMV retinitis and to compare HIV-positive and HIV-negative patients.

Methods

We reviewed medical charts and ocular images of 41 patients with CMV retinitis diagnosed between 1996 and 2019.

Results

Eleven patients (27%) had HIV infection and 30 were immunocompromised from diverse causes. Initial visual acuity, type, zone, and extent of CMV retinitis, and response to anti-CMV treatment were not significantly different between the two groups. Vitreous haze and panretinal occlusive vasculopathy were the presenting features only in non-HIV patients, seen in 34% and 16% of eyes, respectively. Although not statistically significant, recurrent CMV retinitis was more common in non-HIV patients (17.4% vs. 4.3%/eye-year) and immune recovery uveitis was more common in HIV patients (43% vs. 26%/eye-year). Visual outcomes were similar. Final visual acuity of 1 logMAR or worse was significantly associated with the recurrence of CMV retinitis (odds ratio 9.67; p?=?0.01) and also with the occurrence of immune recovery uveitis (odds ratio 4.31; p?=?0.058).

Conclusions

Diverse immunocompromising conditions are more commonly associated with CMV retinitis than HIV infection in Turkish patients. Intraocular inflammation was more commonly associated with active retinitis in non-HIV patients and immune recovery uveitis was more common in HIV patients.

     

Incidence and Risk Factors for Developing Glaucoma Among Patients with Uveitis in a University-based Tertiary Referral Center in Riyadh,Saudi Arabia

Purpose: To investigate the incidence and risk factors of secondary glaucoma among uveitis patients.

Methods: Retrospective review of medical records of 642 patients (1220 eyes).

Results: Glaucoma was diagnosed in 169 (13.9%) eyes and was most common in eyes with anterior uveitis (19.1%) (p?p?Conclusions: Incidence of glaucoma differed depending on anatomic and etiologic diagnoses of uveitis. There is a significant association between severity of inflammation at presentation and development of glaucoma.