title: Factors predictive of remission of new-onset anterior uveitis.
abstract: OBJECTIVE
  To identify factors predictive of remission of inflammation in new-onset anterior uveitis cases treated at tertiary uveitis care facilities.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Patients seeking treatment at participating academic uveitis clinics within 90 days of initial diagnosis of anterior uveitis.
  
  
  METHODS
  Retrospective cohort study based on standardized chart review.
  
  
  METHODS
  Factors predictive of remission (no disease activity without corticosteroid or immunosuppressive treatments at all visits during a 90-day period).
  
  
  RESULTS
  Nine hundred ninety eyes (687 patients) had a first-ever diagnosis of anterior uveitis within 90 days before initial presentation and had follow-up visits thereafter. The median follow-up time was 160 days. Systemic diagnoses with juvenile idiopathic arthritis (JIA; adjusted hazard ratio [aHR], 0.38; 95% confidence interval [CI], 0.19-0.74) and Behçet's disease (aHR, 0.10; 95% CI, 0.01-0.85) were associated with a lower incidence of uveitis remission. Cases of bilateral uveitis (aHR, 0.68; 95% CI, 0.54-0.87) and those with a history of cataract surgery before presentation (aHR, 0.51; 95% CI, 0.29-0.87) also had a lower incidence of remission. Regarding clinical findings at the initial visit, a high degree of vitreous cells at initial presentation was associated with a lower incidence of remission (for 1+ or more vs. none: aHR, 0.72; 95% CI, 0.55-0.95). An initial visual acuity of 20/200 or worse, with respect to 20/40 or better, also was predictive of a lower incidence of remission (aHR, 0.52; 95% CI, 0.32-0.86).
  
  
  CONCLUSIONS
  Factors associated with a lower incidence of remission among new-onset anterior uveitis cases included diagnosis with JIA, Behçet's disease, bilateral uveitis, history of cataract surgery, findings of 1+ or more vitreous cells at presentation, and an initial visual acuity of 20/200 or worse. Patients with these risk factors seem to be at higher risk of persistent inflammation; reciprocally, patients lacking these factors would be more likely to experience remission. Patients with risk factors for nonremission of uveitis should be managed taking into account the higher probability of a chronic inflammatory course.
authors.affiliation: The Massachusetts Eye Research and Surgery Institution, Cambridge, Massachusetts; Department of Ophthalmology, The Scheie Eye Institute, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Pichaporn
authors.initials: P
authors.lastname: Artornsombudh
authors.affiliation: Department of Ophthalmology, The Scheie Eye Institute, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Maxwell
authors.initials: M
authors.lastname: Pistilli
authors.affiliation: The Massachusetts Eye Research and Surgery Institution, Cambridge, Massachusetts; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
authors.forename: C Stephen
authors.initials: CS
authors.lastname: Foster
authors.affiliation: The Massachusetts Eye Research and Surgery Institution, Cambridge, Massachusetts; Om Eye Care Hospital, Belgaum, Karnataka, India.
authors.forename: Siddharth S
authors.initials: SS
authors.lastname: Pujari
authors.affiliation: Department of Surgery, Duke University School of Medicine, Durham, North Carolina; Department of Ophthalmology and Visual Sciences, Fundus Photograph Reading Center, University of Wisconsin School of Medicine, Madison, Wisconsin.
authors.forename: Sapna S
authors.initials: SS
authors.lastname: Gangaputra
authors.affiliation: Department of Ophthalmology, The Icahn School of Medicine at Mount Sinai, New York, New York; Department of Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York; Department of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Jabs
authors.affiliation: Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Grace A
authors.initials: GA
authors.lastname: Levy-Clarke
authors.affiliation: Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Maryland.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Nussenblatt
authors.affiliation: Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon; Department of Medicine, Oregon Health and Science University, Portland, Oregon.
authors.forename: James T
authors.initials: JT
authors.lastname: Rosenbaum
authors.affiliation: Department of Ophthalmology, Oregon Health and Science University, Portland, Oregon; Portland Veteran's Affairs Medical Center, Portland, Oregon.
authors.forename: Eric B
authors.initials: EB
authors.lastname: Suhler
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland; Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Thorne
authors.affiliation: Department of Ophthalmology, The Scheie Eye Institute, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Ophthalmology, Center for Preventive Ophthalmology and Biostatistics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: john.kempen@uphs.upenn.edu.
authors.forename: John H
authors.initials: JH
authors.lastname: Kempen
mesh_terms: D000328:Adult; D001171:Arthritis, Juvenile / Q000175:diagnosis*; D001528:Behcet Syndrome / Q000175:diagnosis*; D002387:Cataract Extraction; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D012307:Risk Factors; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000473:pathology