Remission of Intermediate Uveitis: Incidence and Predictive Factors

• Published in: American journal of ophthalmology Vol. 164; pp. 110 - 117.e2
• Main Authors: Kempen, John H, Gewaily, Dina Y, Newcomb, Craig W, Liesegang, Teresa L, Kaçmaz, R. Oktay, Levy-Clarke, Grace A, Nussenblatt, Robert B, Rosenbaum, James T, Sen, H. Nida, Suhler, Eric B, Thorne, Jennifer E, Foster, C. Stephen, Jabs, Douglas A, Payal, Abhishek, Fitzgerald, Tonetta D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2016; Elsevier Limited
• Subjects: Adolescent; Adult; Age; Cohort Studies; Colleges & universities; Confidence intervals; Disease; Female; Follow-Up Studies; Human subjects; Humans; Incidence; Inflammation; Inflammatory diseases; Male; Middle Aged; Ophthalmology; Population; Remission, Spontaneous; Retrospective Studies; Risk Factors; Survival analysis; Uveitis, Intermediate - diagnosis; Uveitis, Intermediate - epidemiology; Uveitis, Intermediate - physiopathology
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2015.12.034

Purpose To evaluate the incidence of remission among patients with intermediate uveitis; to identify factors potentially predictive of remission. Design Retrospective cohort study. Methods Involved eyes of patients with primary noninfectious intermediate uveitis at 4 academic ocular inflammation subspecialty practices, followed sufficiently long to meet the remission outcome definition, were studied retrospectively by standardized chart review data. Remission of intermediate uveitis was defined as a lack of inflammatory activity at ≥2 visits spanning ≥90 days in the absence of any corticosteroid or immunosuppressant medications. Factors potentially predictive of intermediate uveitis remission were evaluated using survival analysis. Results Among 849 eyes (of 510 patients) with intermediate uveitis followed over 1934 eye-years, the incidence of intermediate uveitis remission was 8.6/100 eye-years (95% confidence interval [CI], 7.4–10.1). Factors predictive of disease remission included prior pars plana vitrectomy (PPV) (hazard ratio [HR] [vs no PPV] = 2.39; 95% CI, 1.42–4.00), diagnosis of intermediate uveitis within the last year (HR [vs diagnosis >5 years ago] =3.82; 95% CI, 1.91–7.63), age ≥45 years (HR [vs age <45 years] = 1.79; 95% CI, 1.03–3.11), female sex (HR = 1.61; 95% CI, 1.04–2.49), and Hispanic race/ethnicity (HR [vs white race] = 2.81; 95% CI, 1.23–6.41). Presence/absence of a systemic inflammatory disease, laterality of uveitis, and smoking status were not associated with differential incidence. Conclusions Our results suggest that intermediate uveitis is a chronic disease with an overall low rate of remission. Recently diagnosed patients and older, female, and Hispanic patients were more likely to remit. With regard to management, pars plana vitrectomy was associated with increased probability of remission.