Lara Borrego-Sanz1, Alejandro Gómez-Gómez2,3, María Gurrea-Almela4, Mar Esteban-Ortega5, Esperanza Pato6, David Díaz-Valle1, Teresa Díaz-Valle4, Santiago Muñoz-Fernández2,3, Luis Rodriguez-Rodriguez7. 1. Ophthalmology Department, Hospital Clínico San Carlos, Madrid, Spain. 2. Rheumatology Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain. 3. School of Medicine, Universidad Complutense de Madrid, Madrid, Spain. 4. Ophthalmology Department, Hospital Universitario de Móstoles, Móstoles, Madrid, Spain. 5. Ophthalmology Department, Hospital Universitario Infanta Sofía, Universidad Europea, San Sebastián de los Reyes, Madrid, Spain. 6. Rheumatology Department and Health Research Institute (IdISSC), Hospital Clínico San Carlos, Prof. Martín Lagos Street, 20840, Madrid, Spain. 7. Rheumatology Department and Health Research Institute (IdISSC), Hospital Clínico San Carlos, Prof. Martín Lagos Street, 20840, Madrid, Spain. lrrodriguez@salud.madrid.org.
Abstract
PURPOSE: To compare the clinical prognosis among selected white dot syndromes (WDS) (birdshot chorioretinopathy (BRC), multifocal choroiditis, serpiginous choroidopathy (SC), and others) and to identify risk factors of poor visual prognosis. METHODS: Retrospective longitudinal cohort study including 84 patients (143 affected eyes) diagnosed with WDS between 1982 and July 2017, followed up until loss of follow-up or December 2017, and recruited from three Uveitis Clinics (Madrid Community, Spain). Our main outcome measures were temporary or permanent moderate (corrected visual acuity in the Snellen scale < 20/50) or severe (< 20/200) vision losses, and development of new ocular complications. Incidence rates (IR) of the main outcome measures were estimated per 100 eye-years. Bivariate and multivariate Cox robust regression models analyzed the association of demographic- and clinical-related variables with vision loss. RESULTS: SC exhibited the greatest IR of vision loss, even in the multivariate models. Previous events of vision loss, presence of choroidal neovascularization, and cataracts exhibited worse visual prognosis. Monotherapy with immunosuppressive drugs but not combine therapy was also associated with higher IR of visual loss. Regarding new ocular complications, BRC showed the highest IR of epiretinal membrane and macular edema. CONCLUSIONS: SC presents the worst visual prognosis. Some ocular manifestations can identify patients with WDS at risk of a worse clinical evolution.
PURPOSE: To compare the clinical prognosis among selected white dot syndromes (WDS) (birdshot chorioretinopathy (BRC), multifocal choroiditis, serpiginous choroidopathy (SC), and others) and to identify risk factors of poor visual prognosis. METHODS: Retrospective longitudinal cohort study including 84 patients (143 affected eyes) diagnosed with WDS between 1982 and July 2017, followed up until loss of follow-up or December 2017, and recruited from three Uveitis Clinics (Madrid Community, Spain). Our main outcome measures were temporary or permanent moderate (corrected visual acuity in the Snellen scale < 20/50) or severe (< 20/200) vision losses, and development of new ocular complications. Incidence rates (IR) of the main outcome measures were estimated per 100 eye-years. Bivariate and multivariate Cox robust regression models analyzed the association of demographic- and clinical-related variables with vision loss. RESULTS: SC exhibited the greatest IR of vision loss, even in the multivariate models. Previous events of vision loss, presence of choroidal neovascularization, and cataracts exhibited worse visual prognosis. Monotherapy with immunosuppressive drugs but not combine therapy was also associated with higher IR of visual loss. Regarding new ocular complications, BRC showed the highest IR of epiretinal membrane and macular edema. CONCLUSIONS: SC presents the worst visual prognosis. Some ocular manifestations can identify patients with WDS at risk of a worse clinical evolution.