Impact of complications in adult anterior uveitis in a Finnish single-centre registry study.

Abstract

Objective: To analyse ocular complications, their surgical treatments and risk factors in anterior uveitis (AU).

Methods and analysis: From a single-centre registry of all adult patients with AU in 2009 (n=413), ocular complications of 641 uveitic eyes, their operative treatments and risk factors were studied comparing patients with or without complications.

Results: A total of 269 (42%) uveitic eyes and 189 (46%) patients had ocular complications. The most common complication was cataract in 217 (34%) eyes. Glaucoma was noted in 69 (11%) eyes, cystoid macular oedema in 39 (6%), posterior synechiae in 30 (5%), band keratopathy and optic disc oedema in 11 (2%), and iris atrophy and cystic corneal oedema in one eye (0.2%). Complications were typically observed in the chronic course of AU, without notable sex difference and with non-infectious aetiology. A steroid response, the course of uveitis, eye involvement, oral, subconjunctival and prophylactic dosage of steroids, methotrexate and immunosuppressants management formed significant risk factors for complication development in AU. Respectively, significant risk was also observed with the steroid response in the development of complications other than glaucoma.

Conclusions: A remarkable portion of eyes affected by AU-two out of five-develop ocular complications during long follow-up. Our results highlight the significance of uveitic inflammation and its corticosteroid treatment leading to earlier onset of cataract, glaucoma and their surgical treatments. For the first time, a significant risk was observed between the number of corticosteroid responders and the development of complications, extending beyond glaucoma. The retrospective design of the study can be considered as the main limitation of the study.