TY - JOUR
T1 - Uveitis in Patients with Autoimmune Hepatitis
AU - Lim, Lyndell L.
AU - Scarborough, John D.
AU - Thorne, Jennifer E.
AU - Graham, Elizabeth
AU - Kempen, John H.
AU - Mackensen, Friederike
AU - Nguyen, Quan Dong
AU - Prabriputaloong, Tisha
AU - Read, Russell W.
AU - Suhler, Eric B.
AU - Schwartz, Jonathan M.
AU - Smith, Justine R.
N1 - Funding Information:
This study was supported by the Research to Prevent Blindness, New York, New York through a Career Development Award to Dr Smith, a Special Scholar Award to Dr Kempen, a Physician-Scientist Award to Dr Read, and unrestricted awards to the Casey Eye Institute, Portland, Oregon, the Scheie Eye Institute, Philadelphia, Pennsylvania, and the University of Alabama at Birmingham, Department of Ophthalmology, Birmingham, Alabama. Dr Smith also received support from the Schnitzer/Novack Foundation, Portland, Oregon. Dr Kempen also received support from the Paul and Evanina Mackall Foundation, Philadelphia, Pennsylvania. Dr Read also received support via an unrestricted Departmental Grant to the University of Alabama at Birmingham and the Department of Ophthalmology from the EyeSight Foundation of Alabama Inc, Birmingham, Alabama. Dr Lim is supported by the Crock-Mankiewicz-Zelkin Fellowship, Victoria, Australia and The Eye Foundation Medical Retina Fellowship, New South Wales, Australia. The authors indicate no financial conflict of interest. Dr Nguyen serves on the Uveitis Advisory Board for Bausch & Lomb Inc. The terms and condition of his services have been reviewed and approved by the Office of Policy Coordination at the Johns Hopkins University. Involved in design and conduct of study (L.L.L., J.D.S., J.M.S., J.R.S.); collection of data (L.L.L., J.D.S., J.E.T., J.H.K., Q.D.N., E.B.S., R.W.R., F.M., E.G., T.P., J.R.S.); management of data (L.L.L., J.D.S.); analysis and interpretation of the data (L.L.L., J.D.S., J.R.S.); preparation of manuscript (L.L.L., J.R.S.); and review and approval of the manuscript (L.L.L., J.D.S., J.M.S., J.E.T., J.H.K., Q.D.N., E.B.S., R.W.R., F.M., E.G., T.P., J.R.S.). This study was approved by the Institutional Review Board of Oregon Health & Science University, Portland, Oregon. This study adheres to the Declaration of Helsinki.
Funding Information:
Lyndell L. Lim, MBBS, FRANZCO, is the Mankiewicz-Zelkin-Crock Senior Research Fellow at the Centre for Eye Research Australia, University of Melbourne, Australia. She is also a Consultant Ophthalmologist specializing in Medical Retina and Ocular Inflammatory Diseases at both the Royal Victorian Eye and Ear Hospital (RVEEH) and Royal Melbourne Hospital. Dr Lim received her medical degree from the University of Melbourne and completed her ophthalmology training at RVEEH. She has also completed two Fellowships in Medical Retina (RVEEH) and Uveitis (Casey Eye Institute, Portland, Oregon). Her areas of research include confocal microscopy in ocular inflammatory diseases and the role of inflammation in Age-Related Macular Degeneration. Dr Lim has authored over 20 peer-reviewed published articles and five book chapters and has received several international research travel grants. Current support includes The Eye Foundation Medical Retina Fellowship (Australia), and the Melbourne University Early Career Researcher Grant.
PY - 2009/2
Y1 - 2009/2
N2 - Purpose: To report seven cases of uveitis occurring in patients with autoimmune hepatitis (AIH), raising the possibility that uveitis may be an extrahepatic feature of AIH. Design: Multicenter, retrospective, observational case series of patients with AIH and uveitis. Methods: One index case was identified at Oregon Health & Science University. Further cases were identified by a web-based survey of members of the American Uveitis Society, the International Uveitis Study Group, the Proctor Foundation mailing list server, and the First SUN International Workshop. Respondents were asked to provide clinical information about uveitis phenotype, AIH features, and treatment. Results: Clinical information was obtained for seven individuals (four females and three males; age range, seven to 67 years) who suffered from AIH and uveitis. Average duration of follow-up was 5.5 years. All patients had chronic, persistent bilateral uveitis that was anterior (n = 3), intermediate (n = 1), or pan (n = 3) in location. Every patient had complications arising from his or her uveitis, including cataract (n = 5), glaucoma (n = 3), cystoid macular edema (n = 3), and posterior synechiae (n = 3). Final visual acuities ranged from 20/16 to hand movements. To treat the uveitis and/or AIH, the majority of patients required oral prednisone and all seven patients were treated with systemic immunosuppression. Conclusion: Despite the small size of this study, our findings suggest an association between AIH and uveitis. The uveitis is chronic, bilateral, and associated with sight-threatening complications, necessitating systemic immunosuppression in some individuals.
AB - Purpose: To report seven cases of uveitis occurring in patients with autoimmune hepatitis (AIH), raising the possibility that uveitis may be an extrahepatic feature of AIH. Design: Multicenter, retrospective, observational case series of patients with AIH and uveitis. Methods: One index case was identified at Oregon Health & Science University. Further cases were identified by a web-based survey of members of the American Uveitis Society, the International Uveitis Study Group, the Proctor Foundation mailing list server, and the First SUN International Workshop. Respondents were asked to provide clinical information about uveitis phenotype, AIH features, and treatment. Results: Clinical information was obtained for seven individuals (four females and three males; age range, seven to 67 years) who suffered from AIH and uveitis. Average duration of follow-up was 5.5 years. All patients had chronic, persistent bilateral uveitis that was anterior (n = 3), intermediate (n = 1), or pan (n = 3) in location. Every patient had complications arising from his or her uveitis, including cataract (n = 5), glaucoma (n = 3), cystoid macular edema (n = 3), and posterior synechiae (n = 3). Final visual acuities ranged from 20/16 to hand movements. To treat the uveitis and/or AIH, the majority of patients required oral prednisone and all seven patients were treated with systemic immunosuppression. Conclusion: Despite the small size of this study, our findings suggest an association between AIH and uveitis. The uveitis is chronic, bilateral, and associated with sight-threatening complications, necessitating systemic immunosuppression in some individuals.
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U2 - 10.1016/j.ajo.2008.08.019
DO - 10.1016/j.ajo.2008.08.019
M3 - Article
C2 - 19166713
AN - SCOPUS:58249098858
SN - 0002-9394
VL - 147
SP - 332-338.e1
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 2
ER -