Factors Predicting Visual Acuity Outcome in Intermediate, Posterior, and Panuveitis: The Multicenter Uveitis Steroid Treatment (MUST) Trial.
Publication/Presentation Date
12-1-2015
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.
Volume
160
Issue
6
First Page
1133
Last Page
1141
ISSN
1879-1891
Published In/Presented At
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., & Multicenter Uveitis Steroid Treatment (MUST) Trial Research Group (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
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
26386159
Department(s)
Administration and Leadership
Document Type
Article