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      Noninfectious Intermediate, Posterior, or Panuveitis: Results from the Retrospective, Observational, International EyeCOPE Study

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          Abstract

          Introduction

          The EyeCOPE study characterized noninfectious intermediate posterior, or panuveitis (NIIPPU) before biologic agents were widely available.

          Methods

          This retrospective, observational study included adults with NIIPPU attending a routine ophthalmological visit. Data were collected from the study visit and medical records.

          Results

          Of 565 patients, 58.8% were female, and the mean age was 41.3 years; 33.8% had idiopathic uveitis and 45.8% had panuveitis. The median time from symptom onset to diagnosis and treatment was 27.0 and 30.5 days, respectively. Patients received immunosuppressants and systemic/local corticosteroids. Most patients experienced substantial decline in ocular function (mean best corrected visual acuity, 0.4 logMAR). Mean total work productivity impairment among employed patients was 31.0%. Most patients reported ocular complications (70.8%) such as vision loss and cataracts.

          Conclusions

          Despite treatment, most patients with NIIPPU experienced a decline in ocular function and ocular complications. There is an unmet need for additional NIIPPU treatment, such as targeted monoclonal antibodies.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s40123-021-00351-4.

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          Most cited references36

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          Standardization of Uveitis Nomenclature for Reporting Clinical Data. Results of the First International Workshop

          Robert Nussenblatt, Douglas A Jabs, James T. Rosenbaum (2005)
          To begin a process of standardizing the methods for reporting clinical data in the field of uveitis. Consensus workshop. Members of an international working group were surveyed about diagnostic terminology, inflammation grading schema, and outcome measures, and the results used to develop a series of proposals to better standardize the use of these entities. Small groups employed nominal group techniques to achieve consensus on several of these issues. The group affirmed that an anatomic classification of uveitis should be used as a framework for subsequent work on diagnostic criteria for specific uveitic syndromes, and that the classification of uveitis entities should be on the basis of the location of the inflammation and not on the presence of structural complications. Issues regarding the use of the terms "intermediate uveitis," "pars planitis," "panuveitis," and descriptors of the onset and course of the uveitis were addressed. The following were adopted: standardized grading schema for anterior chamber cells, anterior chamber flare, and for vitreous haze; standardized methods of recording structural complications of uveitis; standardized definitions of outcomes, including "inactive" inflammation, "improvement'; and "worsening" of the inflammation, and "corticosteroid sparing," and standardized guidelines for reporting visual acuity outcomes. A process of standardizing the approach to reporting clinical data in uveitis research has begun, and several terms have been standardized.
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            Incidence and prevalence of uveitis in Northern California; the Northern California Epidemiology of Uveitis Study.

            David C. Gritz, Ira G. Wong (2004)
            To determine the incidence and prevalence of uveitis in a large, well-defined population in Northern California. Cross-sectional study using retrospective database and medical record review. A group of 2070 people within 6 Northern California medical center communities (N = 731 898) who had a potential diagnosis of uveitis. The patient database of a large health maintenance organization (2 805 443 members at time of the study) was searched for all patients who, during a 12-month period, had the potential diagnosis of uveitis. Detailed quarterly gender- and age-stratified population data were available. Medical records of patients who potentially had uveitis and who were members of the 6 target communities were reviewed by 2 uveitis subspecialists to confirm the diagnosis of uveitis and to establish time of onset. Demographic and clinical data were gathered for patients meeting the clinical definition of uveitis. Incidence rates were calculated by using a dynamic population model. Prevalence rates were based on the mid-study period population. Presence and date of onset of uveitis. At midstudy, the population for the 6 communities was 731 898. During the target period, 382 new cases of uveitis were diagnosed; 462 cases of uveitis were diagnosed before the target period. These data yielded an incidence of 52.4/100 000 person-years and a period prevalence of 115.3/100 000 persons. The incidence and prevalence of disease were lowest in pediatric age groups and were highest in patients 65 years or older (P<0.0001). The prevalence of uveitis was higher in women than in men (P<0.001), but the difference in incidence between men and women was not statistically significant. Comparison between the group of patients who had onset of uveitis before the target period (ongoing uveitis) and the entire cohort of uveitis patients showed that women had a higher prevalence of ongoing uveitis than men and that this difference was largest in the older age groups (P<0.001). In this largest population-based uveitis study in the United States to date, the incidence of uveitis was approximately 3 times that of previous U.S. estimates and increased with the increasing age of patients. Women had a higher prevalence of uveitis than men, and the largest differences were in older age groups.
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              Causes and frequency of blindness in patients with intraocular inflammatory disease.

              A Rothova, M Suttorp-van Schulten, W Frits Treffers … (1996)
              Uveitis, an intraocular inflammatory disease, is a significant cause of visual impairment. It is not known how many patients with uveitis will retain visual acuity and how many develop visual impairment or even blindness. The aim of this study was to assess the frequency of blindness in patients with uveitis and, more specifically, to identify the clinical profile of patients at risk for visual loss. A cross sectional and retrospective study of 582 patients with uveitis who visited the ophthalmology departments of two university hospitals in the Netherlands was performed. Within the group of 582 patients, 203 (35%) exhibited blindness or visual impairment; bilateral legal blindness developed in 22 (4%) patients, 26 (4.5%) had one blind eye with visual impairment of the other, and nine (1.5%) had bilateral visual impairment. Unilateral blindness developed in 82 (14%) patients, whereas 64 (11%) exhibited unilateral visual impairment. The most important cause of both blindness and visual impairment was cystoid macular oedema (29% and 41%, respectively). Complications of uveitis were encountered in more than half of the patients and 23% underwent one or more surgical procedures. When the patients were subdivided according to anatomical site, those with panuveitis had the worst visual prognosis. The systemic diseases associated with a poor visual prognosis were juvenile chronic arthritis and sarcoidosis. Ocular toxoplasmosis was the most frequent cause of unilateral visual loss. Cystoid macular oedema is the most frequent complication of uveitis and its occurrence plays a decisive role in the visual outcome of this disease.
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                Author and article information

                Contributors
                Murat Hasanreisoglu:
                ORCID: http://orcid.org/0000-0001-9885-5653
                rmurat95@yahoo.com
                Journal
                Journal ID (nlm-ta): Ophthalmol Ther
                Journal ID (iso-abbrev): Ophthalmol Ther
                Title: Ophthalmology and Therapy
                Publisher: Springer Healthcare (Cheshire )
                ISSN (Print): 2193-8245
                ISSN (Electronic): 2193-6528
                Publication date (Electronic): 12 June 2021
                Publication date PMC-release: 12 June 2021
                Publication date (Print): September 2021
                Volume: 10
                Issue: 3
                Pages: 565-580
                Affiliations
                [1 ]GRID grid.12136.37, ISNI 0000 0004 1937 0546, Department of Ophthalmology, Rabin Medical Center, Petach Tikva and Sackler School of Medicine, , Tel Aviv University, ; Tel Aviv, Israel
                [2 ]GRID grid.411798.2, ISNI 0000 0000 9100 9940, Department of Ophthalmology, , Charles University and General University Hospital, ; Prague, Czech Republic
                [3 ]GRID grid.9601.e, ISNI 0000 0001 2166 6619, Department of Ophthalmology, Istanbul Faculty of Medicine, , Istanbul University, ; Istanbul, Turkey
                [4 ]GRID grid.445504.4, ISNI 0000 0004 0529 6576, Department of Ophthalmology, , Kharkiv National Medical University, ; Kharkiv, Ukraine
                [5 ]AbbVie Inc., São Paulo, Brazil
                [6 ]GRID grid.467162.0, ISNI 0000 0004 4662 2788, AbbVie Deutschland GmbH & Co. KG, ; Ludwigshafen, Germany
                [7 ]Organización Médica de Investigación, Buenos Aires, Argentina
                [8 ]GRID grid.411249.b, ISNI 0000 0001 0514 7202, Department of Ophthalmology, , Federal University of São Paulo, ; São Paulo, Brazil
                [9 ]GRID grid.25769.3f, ISNI 0000 0001 2169 7132, Department of Ophthalmology, Faculty of Medicine, , Gazi University, ; 13th Floor, Besevler, Cankaya, 06500 Ankara, Turkey
                Author information
                http://orcid.org/0000-0001-9885-5653
                Article
                Publisher ID: 351
                DOI: 10.1007/s40123-021-00351-4
                PMC ID: 8319263
                PubMed ID: 34117983
                SO-VID: 8b5e2c0f-16ef-468a-bfba-814cea3fbb86
                Copyright © © The Author(s) 2021
                License:

                Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

                History
                Date received : 8 March 2021
                Date accepted : 6 May 2021
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100006483, AbbVie;
                Categories
                Subject: Original Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2021

                Keywords: corticosteroid disease burden,disease characteristics,immunosuppressants,noninfectious uveitis,patient-reported outcomes
                Data availability:
                Keywords: corticosteroid disease burden, disease characteristics, immunosuppressants, noninfectious uveitis, patient-reported outcomes

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