Visual Acuity Outcome over Time in Non-Infectious Uveitis

Maxwell Pistilli^{1

2}, Marshall M Joffe³, Sapna S Gangaputra⁴, Siddharth S Pujari⁵, Douglas A Jabs^{6

7

8}, Grace A Levy-Clarke^{9

10}, Robert B Nussenblatt⁸, James T Rosenbaum^{10

11}, H Nida Sen⁸, Eric B Suhler^{10

11

12}, Jennifer E Thorne^{6

13}, Nirali P Bhatt¹, C Stephen Foster^{14

15}, Hosne Begum¹³, Tonetta D Fitzgerald¹, Kurt A Dreger^{1

13}, Michael M Altaweel^{16

17}, Janet T Holbrook^{6

18}, John H Kempen^{15

19

20}; Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Research Group

Affiliations

¹ The Scheie Eye Institute, The University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
² The Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, The University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
³ The Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, The University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
⁴ Department of Ophthalmology and Vision Sciences, Vanderbilt Eye Institute, Nashville, TN, USA.
⁵ Om Eye Care Hospital, Belgaum, India.
⁶ Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
⁷ Departments of Ophthalmology and Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁸ Laboratory of Immunology, National Eye Institute, Bethesda, MD, USA.
⁹ Tampa Bay Uveitis Center, Tampa, FL, USA.
¹⁰ Department of Ophthalmology, Oregon Health and Science University, Portland, OR, USA.
¹¹ Department of Medicine, Oregon Health and Science University, Portland, OR, USA.
¹² Ophthalmology Service, Portland Veteran's Affairs Medical Center, Portland, OR, USA.
¹³ Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
¹⁴ Massachusetts Eye Research and Surgery Institution, Cambridge, MA, USA.
¹⁵ Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
¹⁶ The Fundus Photograph Reading Center, University of Wisconsin School of Medicine, Madison, WI, USA.
¹⁷ Department of Ophthalmology and Vision Sciences, University of Wisconsin School of Medicine, Madison, WI, USA.
¹⁸ Center for Clinical Trials and Synthesis, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
¹⁹ Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USA.
²⁰ MCM Eye Unit, MCM General Hospital and MyungSung Medical School, Addis Ababa, Ethiopia.

PMID: 31821051
PMCID: PMC7282970
DOI: 10.1080/09273948.2019.1687733

Visual Acuity Outcome over Time in Non-Infectious Uveitis

Maxwell Pistilli et al. Ocul Immunol Inflamm. 2021.

. 2021 Aug 18;29(6):1064-1071.

doi: 10.1080/09273948.2019.1687733. Epub 2019 Dec 10.

Authors

Affiliations

¹ The Scheie Eye Institute, The University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
² The Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, The University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
³ The Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, The University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
⁴ Department of Ophthalmology and Vision Sciences, Vanderbilt Eye Institute, Nashville, TN, USA.
⁵ Om Eye Care Hospital, Belgaum, India.
⁶ Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
⁷ Departments of Ophthalmology and Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁸ Laboratory of Immunology, National Eye Institute, Bethesda, MD, USA.
⁹ Tampa Bay Uveitis Center, Tampa, FL, USA.
¹⁰ Department of Ophthalmology, Oregon Health and Science University, Portland, OR, USA.
¹¹ Department of Medicine, Oregon Health and Science University, Portland, OR, USA.
¹² Ophthalmology Service, Portland Veteran's Affairs Medical Center, Portland, OR, USA.
¹³ Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
¹⁴ Massachusetts Eye Research and Surgery Institution, Cambridge, MA, USA.
¹⁵ Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
¹⁶ The Fundus Photograph Reading Center, University of Wisconsin School of Medicine, Madison, WI, USA.
¹⁷ Department of Ophthalmology and Vision Sciences, University of Wisconsin School of Medicine, Madison, WI, USA.
¹⁸ Center for Clinical Trials and Synthesis, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
¹⁹ Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USA.
²⁰ MCM Eye Unit, MCM General Hospital and MyungSung Medical School, Addis Ababa, Ethiopia.

PMID: 31821051
PMCID: PMC7282970
DOI: 10.1080/09273948.2019.1687733

Abstract

Introduction: We evaluated visual acuity (VA) over 5 years in a subspecialty noninfectious uveitis population.Methods: Retrospective data from 5,530 noninfectious uveitis patients with anterior, intermediate, posterior or panuveitis were abstracted by expert reviewers. Mean VA was calculated using inverse probability of censoring weighting to account for losses to follow-up.Results: Patients were a median of 41 years old, 65% female, and 73% white. Initial mean VA was worse among panuveitis (20/84) than posterior (20/64), intermediate (20/47), and anterior (20/37) uveitides. On average, mean VA improved by 0.62, 0.51, 0.37, and 0.26 logMAR-equivalent lines over 2 years, respectively (each P < .001), then remained stable, except posterior uveitis mean VA worsened to initial levels.Conclusion: Mean VA of uveitic eyes improved and, typically, improvement was sustained under uveitis subspecialty care. Because VA tends to improve under tertiary care, mean VA change appears a better outcome for clinical studies than time-to-loss of VA.

Keywords: Uveitis; Visual acuity; inverse probability of censoring weighting.

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Conflict of interest statement

Declaration of Interest Statement

Maxwell Pistilli, Marshall M. Joffe, Sapna S. Gangaputra, Siddharth S. Pujari, Douglas A. Jabs, Grace A. Levy-Clarke, Hosne Begum, Tonetta D. Fitzgerald, and Nirali P. Bhatt, report no conflicts of interest. James T. Rosenbaum serves or has served as a consultant for Abbott Laboratories, Amgen, Allergan, Genentech, Novartis, and UCB and has been involved in clinical trials for Abbott Laboratories, Genentech, Lux Biosciences, and Eyegate Pharma. Jennifer E. Thorne serves a consultant for Allergan and XOMA. C. Stephen Foster serves as a lecturer for Alcon, Inspire, Ista, and Centocor; as a Consultant for Sirion; as a consultant and lecturer for Allergan and Bausch & Lomb; and as an equity owner for EyeGate. John H. Kempen serves or has served in the last three years as a consultant for Clearside, Gilead, and Santen and has received grant funding from EyeGate.

Figures

**Figure 1.**
Estimates of gain and loss of 10 letters Comparison of Kaplan-Meier curves for 10 letters of gain or loss, in the observational Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Cohort and in the Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study Cohort. The shading at the top and bottom (light gray for SITE, dark gray for MUST) indicate the percent of remaining patients who are 10 letters below or above, respectively, their baseline visual acuity.

**Figure 2.**
Mean Visual Acuity (VA) over 5 years after presentation for tertiary care Mean VA and 95% confidence intervals (in gray) for anterior, intermediate, posterior and panuveitis over the first 5 years after presentation for tertiary care. Visits after baseline within successive bins (staggered bars at the bottom of the graph), were modeled as repeated measurements of a single time interval, represented here as the middle of the bin. Data from the Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Cohort Study.

See this image and copyright information in PMC

Comment in

Vision Loss in Uveitis.
E Cunningham ET, Zierhut M. E Cunningham ET, et al. Ocul Immunol Inflamm. 2021 Aug 18;29(6):1037-1039. doi: 10.1080/09273948.2021.2017152. Ocul Immunol Inflamm. 2021. PMID: 35040720 No abstract available.

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Visual Acuity Outcome over Time in Non-Infectious Uveitis

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Visual Acuity Outcome over Time in Non-Infectious Uveitis

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