TY - JOUR
T1 - Exudative Retinal Detachment in Ocular Inflammatory Diseases
T2 - Risk and Predictive Factors
AU - the Systemic Immunosuppressive Therapy for Eye Diseases Research Group
AU - Shah, Deepika N.
AU - Al-Moujahed, Ahmad
AU - Newcomb, Craig W.
AU - Kaçmaz, R. Oktay
AU - Daniel, Ebenezer
AU - Thorne, Jennifer E.
AU - Foster, C. Stephen
AU - Jabs, Douglas A.
AU - Levy-Clarke, Grace A.
AU - Nussenblatt, Robert B.
AU - Rosenbaum, James T.
AU - Sen, H. Nida
AU - Suhler, Eric B.
AU - Bhatt, Nirali P.
AU - Kempen, John H.
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/10
Y1 - 2020/10
N2 - Purpose: This study evaluated the risk and risk factors for exudative retinal detachment (ERD) in ocular inflammatory diseases. Design: Retrospective cohort study. Methods: Patients with noninfectious ocular inflammation had been followed longitudinally between 1978 and 2007 at 4 US subspecialty uveitis centers. The main outcome measurements were occurrences of ERD and predictive factors. Results: A total of 176 of 14,612 eyes with ocular inflammation presented with ERD. Among uveitis cases, Vogt-Koyanagi-Harada syndrome (VKH) (odds ratio [OR] = 109), undifferentiated choroiditis (OR = 9.18), sympathetic ophthalmia (OR = 8.43), primary or secondary panuveitis (OR = 7.09), multifocal choroiditis with panuveitis (OR = 4.51), and “other” forms of posterior uveitis (OR = 16.9) were associated with a higher prevalence of ERD. Among the 9,209 uveitic or scleritic eyes initially free of ERD and followed, 137 incident ERD cases were observed over 28,949 eye-years at risk (incidence rate = 0.47% [0.40%-0.56%/eye-year]). VKH (HR = 13.2), sympathetic ophthalmia (HR = 5.82), undifferentiated choroiditis (HR = 6.03), primary or secondary panuveitis (HR = 4.21), and rheumatoid arthritis (HR = 3.30) were significantly associated with incident ERD. A significant dose-response relationship with the prevalence and incidence of ERD were observed for AC cells and vitreous cell activity. African Americans had significantly higher prevalence and incidence of ERD. Conclusions: Other ocular inflammatory conditions in addition to VKH syndrome and posterior scleritis were associated with increased risk of ERD, indicating that ERD does not necessarily dictate a diagnosis of VKH or posterior scleritis. In addition, the relationship between ERD and inflammatory severity factors implies that inflammation is a key predictive factor associated with developing ERD and requires early and vigorous control.
AB - Purpose: This study evaluated the risk and risk factors for exudative retinal detachment (ERD) in ocular inflammatory diseases. Design: Retrospective cohort study. Methods: Patients with noninfectious ocular inflammation had been followed longitudinally between 1978 and 2007 at 4 US subspecialty uveitis centers. The main outcome measurements were occurrences of ERD and predictive factors. Results: A total of 176 of 14,612 eyes with ocular inflammation presented with ERD. Among uveitis cases, Vogt-Koyanagi-Harada syndrome (VKH) (odds ratio [OR] = 109), undifferentiated choroiditis (OR = 9.18), sympathetic ophthalmia (OR = 8.43), primary or secondary panuveitis (OR = 7.09), multifocal choroiditis with panuveitis (OR = 4.51), and “other” forms of posterior uveitis (OR = 16.9) were associated with a higher prevalence of ERD. Among the 9,209 uveitic or scleritic eyes initially free of ERD and followed, 137 incident ERD cases were observed over 28,949 eye-years at risk (incidence rate = 0.47% [0.40%-0.56%/eye-year]). VKH (HR = 13.2), sympathetic ophthalmia (HR = 5.82), undifferentiated choroiditis (HR = 6.03), primary or secondary panuveitis (HR = 4.21), and rheumatoid arthritis (HR = 3.30) were significantly associated with incident ERD. A significant dose-response relationship with the prevalence and incidence of ERD were observed for AC cells and vitreous cell activity. African Americans had significantly higher prevalence and incidence of ERD. Conclusions: Other ocular inflammatory conditions in addition to VKH syndrome and posterior scleritis were associated with increased risk of ERD, indicating that ERD does not necessarily dictate a diagnosis of VKH or posterior scleritis. In addition, the relationship between ERD and inflammatory severity factors implies that inflammation is a key predictive factor associated with developing ERD and requires early and vigorous control.
UR - http://www.scopus.com/inward/record.url?scp=85089491755&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2020.06.019
DO - 10.1016/j.ajo.2020.06.019
M3 - Article
C2 - 32621891
AN - SCOPUS:85089491755
SN - 0002-9394
VL - 218
SP - 279
EP - 287
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
ER -