title: Predictors of Long-Term Visual Outcome in Intermediate Uveitis.
abstract: To describe factors that predict visual loss and complications in intermediate uveitis.
  
  
  
  Cross-sectional study.
  
  
  
  Subjects with intermediate uveitis were identified from a database of 1254 uveitis patients seen in the clinic of a single consultant (S.L.L.) between 2011 and 2013.
  
  
  
  Information was gathered from the clinical notes of all subjects examined in clinic.
  
  
  
  Best-corrected visual acuity (BCVA), moderate visual loss (MVL; ≤20/50), severe visual loss (SVL; ≤20/200).
  
  
  
  Three hundred and five subjects (550 eyes) were included in the study, comprising 24.3% of subjects seen in clinic. Mean (± standard deviation) age at diagnosis was 40.9±16.9 years, and 64.6% of subjects were female. Median follow-up was 8.2 years (mean, 9.7 years, 5452 eye-years). Systemic diagnosis was made in 36.1% of patients, with sarcoidosis (22.6%) and multiple sclerosis (4.6%) the most frequent systemic associations. Median BCVA was 20/30 (mean logarithm of the minimum angle of resolution [logMAR] 0.26±0.38, n = 550 eyes) at presentation, 20/30 (mean logMAR 0.22±0.42, n = 430) at 5 years, and 20/30 (mean logMAR 0.23±0.46, n = 260) at 10 years. Macular edema was observed in 224 eyes (40.7%) and was associated with idiopathic disease (P = 0.001) and diabetes (P = 0.001). Topical therapy was used in 82.7%, and 34.2% received local injections of corticosteroids. A total of 50.5% required oral steroids and 13.8% required second-line immunosuppression. Subjects with a diagnosis of sarcoidosis were less likely to require a second-line agent (4.3% vs. 16.2%, P = 0.011). On multivariate analysis, visual acuity at referral, retinal pigment epithelial atrophy, and macular scarring were associated with increased risk of MVL; and visual acuity at referral, local therapy, macular scarring, retinal detachment, and hypotony and phthisis were associated with increased risk of SVL.
  
  
  
  Intermediate uveitis has a long disease course with frequent complications and often requires systemic treatment. Despite this, most subjects are still able to achieve good long-term visual outcomes.
authors.affiliation: Department of Clinical Ophthalmology, Moorfields Eye Hospital, London, United Kingdom; University College London (UCL), Institute of Ophthalmology, London, United Kingdom.
authors.forename: Rachael L
authors.initials: RL
authors.lastname: Niederer
authors.affiliation: Department of Clinical Ophthalmology, Moorfields Eye Hospital, London, United Kingdom; University College London (UCL), Institute of Ophthalmology, London, United Kingdom.
authors.forename: Lazha
authors.initials: L
authors.lastname: Sharief
authors.affiliation: Department of Clinical Ophthalmology, Moorfields Eye Hospital, London, United Kingdom.
authors.forename: Asaf
authors.initials: A
authors.lastname: Bar
authors.affiliation: Department of Clinical Ophthalmology, Moorfields Eye Hospital, London, United Kingdom; University College London (UCL), Institute of Ophthalmology, London, United Kingdom.
authors.forename: Sue L
authors.initials: SL
authors.lastname: Lightman
authors.affiliation: Department of Clinical Ophthalmology, Moorfields Eye Hospital, London, United Kingdom; University College London (UCL), Institute of Ophthalmology, London, United Kingdom; School of Medicine, Technion, Israel Institute of Technology, Haifa, Israel. Electronic address: o.tomkins-netzer@ucl.ac.uk.
authors.forename: Oren
authors.initials: O
authors.lastname: Tomkins-Netzer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000209:etiology / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015867:Uveitis, Intermediate / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D015354:Vision, Low / Q000209:etiology / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D005938:Glucocorticoids