Elliot S. Crane*1, May Shum1, Jason Kim1, Eliott Kim1, Alexander B. Crane1, David S. Chu1, 2
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Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ.
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Metropolitan Eye Research and Surgery Institute, Palisades Park, NJ.
*Presenting Author: 973-902-9281, cranees@njms.rutgers.edu, Rutgers New Jersey Medical School
Abstract
Purpose:
To describe the features, treatment outcomes, and complications of intermediate uveitis.
Methods:
This is a retrospective case series of patients with intermediate uveitis and pars planitis identified at the Metropolitan Eye Research and Surgery Institute and Rutgers New Jersey Medical School between 2011 and 2016 with at least six months of follow up. Epidemiology, associated inflammatory conditions, complications, visual outcome, and intraocular inflammation. Modified logMAR notation was used for calculations involving best corrected visual acuity (BCVA). We considered active inflammation as a grade of 1+ or worse in any of anterior chamber cell or flair, or vitreous cell or haze. From 38 patients identified with intermediate uveitis, 28 met inclusion criteria.
Results:
Twenty-eight patients were included (16 [57%] female, mean age 33 ± 20 years at first visit, mean follow up time 4.7 ± 3.4 years). Twenty (71%) were treated with methotrexate, 9 (32%) with adalimumab, and 7 (25%) with mycophenolate mofetil. Seventy-nine percent of our patients required intraocular surgery or injections and many developed cataracts (20, 71%) and glaucoma (12, 43%). Most patients had no associated systemic inflammatory condition (17, 65%). Three (11%) each were diagnosed with Lyme disease and sarcoidosis, two (7%) with multiple sclerosis, and one (4%) each had Crohn’s disease and was HLA-B27 positive. Seventeen (61%) patients had active inflammation on first visit; the inflammation resolved by second visit for five (29%) patients. Twenty-nine of 31 (94%) and 36/37 (97%) patients had at least 20/50 BCVA at their 1 year and last visit, respectively. All 31 (100%) and 36/37 (97%) patients had at least 20/200 BCVA at their 1 year and last visit, respectively.
Conclusions:
Ocular inflammation in patients with intermediate uveitis can be effectively managed with systemic anti-inflammatory treatment with good visual outcomes.