Multifocal Choroiditis with Panuveitis. Incidence of Ocular Complications and of Loss of Visual Acuity

Jennifer Thorne, Susan Wittenberg, Douglas Jabs, George B. Peters, Terry L. Reed, Sanjay R. Kedhar, James P. Dunn

Research output: Contribution to journalArticle

Abstract

Purpose: To estimate the incidences of ocular complications and vision loss in patients with multifocal choroiditis with panuveitis (MFCPU) and to describe the association between therapy and the incidences thereof. Design: Retrospective cohort study. Participants: Sixty-six patients (122 eyes) with MFCPU evaluated from January 1984 through June 2005 at a single-center academic practice. Methods: Demographic and clinical information on patients diagnosed with MFCPU was collected and entered into a computerized database for statistical analyses. Main Outcome Measures: Development of ocular complications, including choroidal neovascularization, epiretinal membrane, and cystoid macular edema (CME), and loss of visual acuity (VA) to 20/50 or worse and to 20/200 or worse. Results: Among affected eyes of patients with MFCPU, frequencies of VAs of 20/50 or worse and of 20/200 or worse at presentation were 55% and 38%, respectively. Choroidal neovascularization was observed in 22% of affected eyes at presentation and was the leading cause of poor VA at presentation. The incidence rates of vision loss to 20/50 or worse and to 20/200 or worse were 0.19/eye-year (EY) and 0.12/EY in affected eyes and 0.07/person-year (PY) and 0.04/PY in better-seeing eyes. Choroidal neovascularization was the most common cause of incident vision loss, with approximately 45% of incident vision loss attributed to new-onset or recurrent choroidal neovascularization. Presence of epiretinal membrane and CME also was associated with the development of vision loss during follow-up. When taken in combination, the incidence of any posterior pole complication was 0.13/EY in affected eyes. Use of immunosuppressive drug therapy (but not low-dose corticosteroid therapy) was associated with an 83% reduction in the risk of posterior pole complications (P = 0.004) and with a 92% reduction in the risk of 20/200 or worse VA in affected eyes (P = 0.05). Of the 6 eyes with recurrent choroidal neovascularization, only one recurrence was observed, in a patient receiving immunosuppressive drug therapy. Conclusions: Treatment with immunosuppressive drugs may improve VA outcomes among patients with MFCPU by reducing the risk of sight-threatening posterior pole complications, including new-onset choroidal neovascularization and recurrent choroidal neovascularization among eyes with existing choroidal neovascularization.

Original languageEnglish (US)
Pages (from-to)2310-2316
Number of pages7
JournalOphthalmology
Volume113
Issue number12
DOIs
StatePublished - Dec 2006

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Panuveitis
Visual Acuity
Choroidal Neovascularization
Incidence
Immunosuppressive Agents
Epiretinal Membrane
Macular Edema
Risk Reduction Behavior
Multifocal choroiditis
Drug Therapy

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Multifocal Choroiditis with Panuveitis. Incidence of Ocular Complications and of Loss of Visual Acuity. / Thorne, Jennifer; Wittenberg, Susan; Jabs, Douglas; Peters, George B.; Reed, Terry L.; Kedhar, Sanjay R.; Dunn, James P.

In: Ophthalmology, Vol. 113, No. 12, 12.2006, p. 2310-2316.

Research output: Contribution to journalArticle

Thorne, Jennifer ; Wittenberg, Susan ; Jabs, Douglas ; Peters, George B. ; Reed, Terry L. ; Kedhar, Sanjay R. ; Dunn, James P. / Multifocal Choroiditis with Panuveitis. Incidence of Ocular Complications and of Loss of Visual Acuity. In: Ophthalmology. 2006 ; Vol. 113, No. 12. pp. 2310-2316.
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title = "Multifocal Choroiditis with Panuveitis. Incidence of Ocular Complications and of Loss of Visual Acuity",
abstract = "Purpose: To estimate the incidences of ocular complications and vision loss in patients with multifocal choroiditis with panuveitis (MFCPU) and to describe the association between therapy and the incidences thereof. Design: Retrospective cohort study. Participants: Sixty-six patients (122 eyes) with MFCPU evaluated from January 1984 through June 2005 at a single-center academic practice. Methods: Demographic and clinical information on patients diagnosed with MFCPU was collected and entered into a computerized database for statistical analyses. Main Outcome Measures: Development of ocular complications, including choroidal neovascularization, epiretinal membrane, and cystoid macular edema (CME), and loss of visual acuity (VA) to 20/50 or worse and to 20/200 or worse. Results: Among affected eyes of patients with MFCPU, frequencies of VAs of 20/50 or worse and of 20/200 or worse at presentation were 55{\%} and 38{\%}, respectively. Choroidal neovascularization was observed in 22{\%} of affected eyes at presentation and was the leading cause of poor VA at presentation. The incidence rates of vision loss to 20/50 or worse and to 20/200 or worse were 0.19/eye-year (EY) and 0.12/EY in affected eyes and 0.07/person-year (PY) and 0.04/PY in better-seeing eyes. Choroidal neovascularization was the most common cause of incident vision loss, with approximately 45{\%} of incident vision loss attributed to new-onset or recurrent choroidal neovascularization. Presence of epiretinal membrane and CME also was associated with the development of vision loss during follow-up. When taken in combination, the incidence of any posterior pole complication was 0.13/EY in affected eyes. Use of immunosuppressive drug therapy (but not low-dose corticosteroid therapy) was associated with an 83{\%} reduction in the risk of posterior pole complications (P = 0.004) and with a 92{\%} reduction in the risk of 20/200 or worse VA in affected eyes (P = 0.05). Of the 6 eyes with recurrent choroidal neovascularization, only one recurrence was observed, in a patient receiving immunosuppressive drug therapy. Conclusions: Treatment with immunosuppressive drugs may improve VA outcomes among patients with MFCPU by reducing the risk of sight-threatening posterior pole complications, including new-onset choroidal neovascularization and recurrent choroidal neovascularization among eyes with existing choroidal neovascularization.",
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T1 - Multifocal Choroiditis with Panuveitis. Incidence of Ocular Complications and of Loss of Visual Acuity

AU - Thorne, Jennifer

AU - Wittenberg, Susan

AU - Jabs, Douglas

AU - Peters, George B.

AU - Reed, Terry L.

AU - Kedhar, Sanjay R.

AU - Dunn, James P.

PY - 2006/12

Y1 - 2006/12

N2 - Purpose: To estimate the incidences of ocular complications and vision loss in patients with multifocal choroiditis with panuveitis (MFCPU) and to describe the association between therapy and the incidences thereof. Design: Retrospective cohort study. Participants: Sixty-six patients (122 eyes) with MFCPU evaluated from January 1984 through June 2005 at a single-center academic practice. Methods: Demographic and clinical information on patients diagnosed with MFCPU was collected and entered into a computerized database for statistical analyses. Main Outcome Measures: Development of ocular complications, including choroidal neovascularization, epiretinal membrane, and cystoid macular edema (CME), and loss of visual acuity (VA) to 20/50 or worse and to 20/200 or worse. Results: Among affected eyes of patients with MFCPU, frequencies of VAs of 20/50 or worse and of 20/200 or worse at presentation were 55% and 38%, respectively. Choroidal neovascularization was observed in 22% of affected eyes at presentation and was the leading cause of poor VA at presentation. The incidence rates of vision loss to 20/50 or worse and to 20/200 or worse were 0.19/eye-year (EY) and 0.12/EY in affected eyes and 0.07/person-year (PY) and 0.04/PY in better-seeing eyes. Choroidal neovascularization was the most common cause of incident vision loss, with approximately 45% of incident vision loss attributed to new-onset or recurrent choroidal neovascularization. Presence of epiretinal membrane and CME also was associated with the development of vision loss during follow-up. When taken in combination, the incidence of any posterior pole complication was 0.13/EY in affected eyes. Use of immunosuppressive drug therapy (but not low-dose corticosteroid therapy) was associated with an 83% reduction in the risk of posterior pole complications (P = 0.004) and with a 92% reduction in the risk of 20/200 or worse VA in affected eyes (P = 0.05). Of the 6 eyes with recurrent choroidal neovascularization, only one recurrence was observed, in a patient receiving immunosuppressive drug therapy. Conclusions: Treatment with immunosuppressive drugs may improve VA outcomes among patients with MFCPU by reducing the risk of sight-threatening posterior pole complications, including new-onset choroidal neovascularization and recurrent choroidal neovascularization among eyes with existing choroidal neovascularization.

AB - Purpose: To estimate the incidences of ocular complications and vision loss in patients with multifocal choroiditis with panuveitis (MFCPU) and to describe the association between therapy and the incidences thereof. Design: Retrospective cohort study. Participants: Sixty-six patients (122 eyes) with MFCPU evaluated from January 1984 through June 2005 at a single-center academic practice. Methods: Demographic and clinical information on patients diagnosed with MFCPU was collected and entered into a computerized database for statistical analyses. Main Outcome Measures: Development of ocular complications, including choroidal neovascularization, epiretinal membrane, and cystoid macular edema (CME), and loss of visual acuity (VA) to 20/50 or worse and to 20/200 or worse. Results: Among affected eyes of patients with MFCPU, frequencies of VAs of 20/50 or worse and of 20/200 or worse at presentation were 55% and 38%, respectively. Choroidal neovascularization was observed in 22% of affected eyes at presentation and was the leading cause of poor VA at presentation. The incidence rates of vision loss to 20/50 or worse and to 20/200 or worse were 0.19/eye-year (EY) and 0.12/EY in affected eyes and 0.07/person-year (PY) and 0.04/PY in better-seeing eyes. Choroidal neovascularization was the most common cause of incident vision loss, with approximately 45% of incident vision loss attributed to new-onset or recurrent choroidal neovascularization. Presence of epiretinal membrane and CME also was associated with the development of vision loss during follow-up. When taken in combination, the incidence of any posterior pole complication was 0.13/EY in affected eyes. Use of immunosuppressive drug therapy (but not low-dose corticosteroid therapy) was associated with an 83% reduction in the risk of posterior pole complications (P = 0.004) and with a 92% reduction in the risk of 20/200 or worse VA in affected eyes (P = 0.05). Of the 6 eyes with recurrent choroidal neovascularization, only one recurrence was observed, in a patient receiving immunosuppressive drug therapy. Conclusions: Treatment with immunosuppressive drugs may improve VA outcomes among patients with MFCPU by reducing the risk of sight-threatening posterior pole complications, including new-onset choroidal neovascularization and recurrent choroidal neovascularization among eyes with existing choroidal neovascularization.

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