Multifocal choroiditis with panuveitis incidence of ocular complications and of loss of visual acuity.
Publication/Presentation Date
12-1-2006
Abstract
PURPOSE: To estimate the incidences of ocular complications and vision loss in patients with multifocal choroiditis with panuveitis (MFCPU) and to describe the association between therapy and the incidences thereof.
DESIGN: Retrospective cohort study.
PARTICIPANTS: Sixty-six patients (122 eyes) with MFCPU evaluated from January 1984 through June 2005 at a single-center academic practice.
METHODS: Demographic and clinical information on patients diagnosed with MFCPU was collected and entered into a computerized database for statistical analyses.
MAIN OUTCOME MEASURES: Development of ocular complications, including choroidal neovascularization, epiretinal membrane, and cystoid macular edema (CME), and loss of visual acuity (VA) to 20/50 or worse and to 20/200 or worse.
RESULTS: Among affected eyes of patients with MFCPU, frequencies of VAs of 20/50 or worse and of 20/200 or worse at presentation were 55% and 38%, respectively. Choroidal neovascularization was observed in 22% of affected eyes at presentation and was the leading cause of poor VA at presentation. The incidence rates of vision loss to 20/50 or worse and to 20/200 or worse were 0.19/eye-year (EY) and 0.12/EY in affected eyes and 0.07/person-year (PY) and 0.04/PY in better-seeing eyes. Choroidal neovascularization was the most common cause of incident vision loss, with approximately 45% of incident vision loss attributed to new-onset or recurrent choroidal neovascularization. Presence of epiretinal membrane and CME also was associated with the development of vision loss during follow-up. When taken in combination, the incidence of any posterior pole complication was 0.13/EY in affected eyes. Use of immunosuppressive drug therapy (but not low-dose corticosteroid therapy) was associated with an 83% reduction in the risk of posterior pole complications (P = 0.004) and with a 92% reduction in the risk of 20/200 or worse VA in affected eyes (P = 0.05). Of the 6 eyes with recurrent choroidal neovascularization, only one recurrence was observed, in a patient receiving immunosuppressive drug therapy.
CONCLUSIONS: Treatment with immunosuppressive drugs may improve VA outcomes among patients with MFCPU by reducing the risk of sight-threatening posterior pole complications, including new-onset choroidal neovascularization and recurrent choroidal neovascularization among eyes with existing choroidal neovascularization.
Volume
113
Issue
12
First Page
2310
Last Page
2316
ISSN
1549-4713
Published In/Presented At
Thorne, J. E., Wittenberg, S., Jabs, D. A., Peters, G. B., Reed, T. L., Kedhar, S. R., & Dunn, J. P. (2006). Multifocal choroiditis with panuveitis incidence of ocular complications and of loss of visual acuity. Ophthalmology, 113(12), 2310–2316. https://doi.org/10.1016/j.ophtha.2006.05.067
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
16996607
Department(s)
Administration and Leadership
Document Type
Article