Pattern of non-infectious uveitis and visual outcome in a tertiary care university-based hospital: A multidisciplinary approach

Abstract

Aim of the work

To study the pattern of non-infectious uveitis (NIU) in different systemic autoimmune diseases and to determine the visual outcome and complications in relation to systemic immunomodulatory therapy.

Patients and methods

The study was conducted on 105 NIU patients with different autoimmune diseases: Behçet’s disease (BD), Vogt–Koyanagi–Harada (VKH), juvenile idiopathic arthritis (JIA), sarcoidosis, idiopathic uveitis and ankylosing spondylitis (AS). All patients were subjected to full ophthalmological examination.

Results

The frequency of NIU was highest in BD (n = 61;58.1 %) followed by VKH (n = 24;22.9 %), JIA (n = 8;7.6 %), sarcoidosis (n = 7;6.7 %), idiopathic uveitis (n = 4;3.8 %) and AS(n = 1;1%) and their mean age at NIU onset was 30 ± 12 years. Panuveitis (PanU) was identified in 84 (80 %), anterior uveitis (AU) in 11(10.5 %), posterior uveitis (PU) in 9 (8.6 %) and intermediate uveitis (IU) in one (1 %) patient. A chronic recurrent course was detected in 98 (93.3 %) patients and bilateral involvement was present in 86 (81.9 %). Laterality of eye affection (unilateral or bilateral) was not related to eye activity or type of uveitis. The most common complication was cataract (17.1 %). A significant relation was found between the control of eye activity and immunosuppression intake in the last 6 months (p = 0.002). 38 (36.2 %) patients were considered legally blind. A non-significant relation was found between legal blindness with type of uveitis (p = 0.82), immunosuppressives(p = 0.06) or biological therapy (p = 0.35).

Conclusion

The most common pattern of NIU in systemic autoimmune diseases was panuveitis. Behçet’s disease and VKH disease were the most frequent etiologies for NIU and cataract was the most common complication.