title: Long-term clinical outcome and causes of vision loss in patients with uveitis.
abstract: OBJECTIVE
  To evaluate the long-term clinical and functional outcome, risks, and causes of vision loss and burden of disease among patients with uveitis.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  The study included 1076 patients diagnosed with uveitis who attended the uveitis clinic at Moorfields Eye Hospital, London, United Kingdom, between 2011 and 2013.
  
  
  METHODS
  Information was gathered from the notes of all patients who were examined in the clinic.
  
  
  METHODS
  Best-corrected visual acuity (BCVA), causes of moderate vision loss (MVL; 20/50-20/120), and severe vision loss (SVL; ≤ 20/200).
  
  
  RESULTS
  The study included 1799 eyes of 1076 patients with an average follow-up of 7.97 ± 0.17 years (median, 5.6 years; range, 1 month-54 years; 8159 patient-years; 14 226 eye-years). Average BCVA remained stable for patients with anterior uveitis (20/30 at baseline to 20/33 at 10 years), as well as for those with nonanterior uveitis (20/50 at baseline to 20/47 at 10 years). Vision loss was noted in 19.2% of eyes, with an incidence for MVL of 0.01 per eye-year or 0.02 per patient-year and for SVL of 0.01 per eye-year or 0.02 per patient-year. Patients were more at risk of vision loss if they had non-anterior uveitis disease, vitreous opacities, retinal detachment, cystoid macular edema (CME), macular scarring, macular hole, optic neuropathy, or macular ischemia. Chronic CME was the most common cause of MVL (3.55%), and macular scarring was the most common cause for irreversible SVL (4%). Among 525 patients (48.7%) who received oral prednisolone, 320 (61%) required a dose of more than 40 mg/day and 130 (24.8%) also required 1 or more second-line agents. Patients were reviewed on average 33.7 ± 0.7 times or 5.9 ± 0.46 times/year.
  
  
  CONCLUSIONS
  Long-term functional outcome among uveitis patients is good, with BCVA remaining stable for more than 10 years of follow-up. In cases when vision loss occurs, it is related mainly to retinal changes. The burden on clinical services is similar regardless of the severity of disease or the risk of vision loss.
authors.affiliation: Moorfields Eye Hospital, London, United Kingdom; Institute of Ophthalmology, University College of London, London, United Kingdom.
authors.forename: Oren
authors.initials: O
authors.lastname: Tomkins-Netzer
authors.affiliation: Moorfields Eye Hospital, London, United Kingdom; Institute of Ophthalmology, University College of London, London, United Kingdom.
authors.forename: Lazha
authors.initials: L
authors.lastname: Talat
authors.affiliation: Moorfields Eye Hospital, London, United Kingdom; Institute of Ophthalmology, University College of London, London, United Kingdom.
authors.forename: Asaf
authors.initials: A
authors.lastname: Bar
authors.affiliation: Institute of Ophthalmology, University College of London, London, United Kingdom.
authors.forename: Albert
authors.initials: A
authors.lastname: Lula
authors.affiliation: Royal Surrey County Hospital, Egerton Road, Guildford, United Kingdom; Division of Immunology & Inflammation, Faculty of Medicine, Imperial College London, London, United Kingdom.
authors.forename: Simon R J
authors.initials: SR
authors.lastname: Taylor
authors.affiliation: Moorfields Eye Hospital, London, United Kingdom; Institute of Ophthalmology, University College of London, London, United Kingdom.
authors.forename: Lavnish
authors.initials: L
authors.lastname: Joshi
authors.affiliation: Moorfields Eye Hospital, London, United Kingdom; Institute of Ophthalmology, University College of London, London, United Kingdom. Electronic address: s.lightman@ucl.ac.uk.
authors.forename: Sue
authors.initials: S
authors.lastname: Lightman
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001766:Blindness / Q000209:etiology*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D006113:United Kingdom; D014605:Uveitis / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D015354:Vision, Low / Q000209:etiology*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents