Christine Goodchild1,2, Micheal O'Rourke1,2, Muhammad Haroon3, Oliver FitzGerald4, Conor C Murphy5,6. 1. Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland. 2. RCSI School of Medicine, Dublin, Ireland. 3. Department of Rheumatology, University Hospital Kerry, Kerry, Ireland. 4. Department of Rheumatology, St. Vincent's University Hospital, Dublin, Ireland. 5. Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland. conorcmurphy@rcsi.ie. 6. RCSI School of Medicine, Dublin, Ireland. conorcmurphy@rcsi.ie.
Abstract
INTRODUCTION: Acute anterior uveitis (AAU) is a frequently encountered form of uveitis, most commonly an immune-mediated condition associated with the HLA-B27 gene with or without spondyloarthritis, or idiopathic in nature. This study's aim was to measure clinical and patient-reported outcomes 5 years after the first episode of immune-mediated AAU. METHODS: This is a longitudinal observational study. Ninety-six patients who underwent evaluation at the time of presentation with their first episode of AAU were invited to return for evaluation 5 years later. Standardised ocular history, clinical examination and quality of life (QOL) assessment with the Short Form 36 (SF-36) and the Vision Core Measure 1 (VCM 1) questionnaire were completed and analysed. RESULTS: Fifty-four patients (56%) returned for subsequent assessment. Physical function was the only sub scale domain of the SF-36 that had significantly deteriorated over the 5 years since the first episode of AAU (45.95 vs. 49.37, p = 0.003). Only 7.4% (n = 4) of patients expressed "more than a little concern" regarding their vision, reflected by a VCM1 score of 2.0 or more. At 5 years, the mean best corrected visual acuity (BCVA) of eyes affected by AAU was LogMAR 0.02 and only 3% (n = 2) of eyes had a BCVA of less than Logmar of 0.3. Five affected eyes (8%) had developed cataract and no patients had developed glaucoma by the 5 year review. CONCLUSIONS: This study demonstrates that immune-mediated AAU has an excellent 5 year prognosis with minimal impact on patients' health and vision-related quality of life.
INTRODUCTION: Acute anterior uveitis (AAU) is a frequently encountered form of uveitis, most commonly an immune-mediated condition associated with the HLA-B27 gene with or without spondyloarthritis, or idiopathic in nature. This study's aim was to measure clinical and patient-reported outcomes 5 years after the first episode of immune-mediated AAU. METHODS: This is a longitudinal observational study. Ninety-six patients who underwent evaluation at the time of presentation with their first episode of AAU were invited to return for evaluation 5 years later. Standardised ocular history, clinical examination and quality of life (QOL) assessment with the Short Form 36 (SF-36) and the Vision Core Measure 1 (VCM 1) questionnaire were completed and analysed. RESULTS: Fifty-four patients (56%) returned for subsequent assessment. Physical function was the only sub scale domain of the SF-36 that had significantly deteriorated over the 5 years since the first episode of AAU (45.95 vs. 49.37, p = 0.003). Only 7.4% (n = 4) of patients expressed "more than a little concern" regarding their vision, reflected by a VCM1 score of 2.0 or more. At 5 years, the mean best corrected visual acuity (BCVA) of eyes affected by AAU was LogMAR 0.02 and only 3% (n = 2) of eyes had a BCVA of less than Logmar of 0.3. Five affected eyes (8%) had developed cataract and no patients had developed glaucoma by the 5 year review. CONCLUSIONS: This study demonstrates that immune-mediated AAU has an excellent 5 year prognosis with minimal impact on patients' health and vision-related quality of life.
Authors: Claudia Fabiani; Antonio Vitale; Ida Orlando; Marco Capozzoli; Fiorella Fusco; Francesco Rana; Rossella Franceschini; Jurgen Sota; Bruno Frediani; Mauro Galeazzi; Gian Marco Tosi; Luca Cantarini Journal: Isr Med Assoc J Date: 2017-08 Impact factor: 0.892