title: Factors Predicting Visual Acuity Outcome in Intermediate, Posterior, and Panuveitis: The Multicenter Uveitis Steroid Treatment (MUST) Trial.
abstract: OBJECTIVE
  To identify factors associated with best-corrected visual acuity (BCVA) presentation and 2-year outcome in 479 intermediate, posterior, and panuveitic eyes.
  
  
  METHODS
  Cohort study using randomized controlled trial data.
  
  
  METHODS
  Multicenter Uveitis Steroid Treatment (MUST) Trial masked BCVA measurements at baseline and at 2 years follow-up used gold-standard methods. Twenty-three clinical centers documented characteristics per protocol, which were evaluated as potential predictive factors for baseline BCVA and 2-year change in BCVA.
  
  
  RESULTS
  Baseline factors significantly associated with reduced BCVA included age ≥50 vs <50 years; posterior vs intermediate uveitis; uveitis duration >10 vs <6 years; anterior chamber (AC) flare >grade 0; cataract; macular thickening; and exudative retinal detachment. Over 2 years, eyes better than 20/50 and 20/50 or worse at baseline improved, on average, by 1 letter (P = .52) and 10 letters (P < .001), respectively. Both treatment groups and all sites of uveitis improved similarly. Factors associated with improved BCVA included resolution of active AC cells, resolution of macular thickening, and cataract surgery in an initially cataractous eye. Factors associated with worsening BCVA included longer duration of uveitis (6-10 or >10 vs <6 years), incident AC flare, cataract at both baseline and follow-up, pseudophakia at baseline, persistence or incidence of vitreous haze, and incidence of macular thickening.
  
  
  CONCLUSIONS
  Intermediate, posterior, and panuveitis have a similarly favorable prognosis with both systemic and fluocinolone acetonide implant treatment. Eyes with more prolonged/severe inflammatory damage and/or inflammatory findings initially or during follow-up have a worse visual acuity prognosis. The results indicate the value of implementing best practices in managing inflammation.
authors.affiliation: Ocular Inflammation Service, Department of Ophthalmology/Scheie Eye Institute, The University of Pennsylvania, Philadelphia, Pennsylvania; Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology/Scheie Eye Institute, The University of Pennsylvania, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, The University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: john.kempen@uphs.upenn.edu.
authors.forename: John H
authors.initials: JH
authors.lastname: Kempen
authors.affiliation: Center for Clinical Trials, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Van Natta
authors.affiliation: Fundus Photograph Reading Center, Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Altaweel
authors.affiliation: Mid-Atlantic Retina, Philadelphia, Pennsylvania; Wills Eye Hospital, Philadelphia, Pennsylvania.
authors.forename: James P
authors.initials: JP
authors.lastname: Dunn
authors.affiliation: Center for Clinical Trials, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; 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.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Jabs
authors.affiliation: University College London Institute of Ophthalmology, London, United Kingdom; Moorfields Eye Hospital, London, United Kingdom.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Lightman
authors.affiliation: Center for Clinical Trials, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, 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: Center for Clinical Trials, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Janet T
authors.initials: JT
authors.lastname: Holbrook
mesh_terms: D000368:Aged; D004343:Drug Implants; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015864:Panuveitis / Q000175:diagnosis / Q000188:drug therapy*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D004343:Drug Implants; D005938:Glucocorticoids