Factors Predicting Visual Acuity Outcome in Intermediate, Posterior, and Panuveitis: The Multicenter Uveitis Steroid Treatment (MUST) Trial.

Michael Altaweel // Publications // Dec 01 2015

PubMed ID: 26386159

Author(s): Kempen JH, Van Natta ML, Altaweel MM, Dunn JP, Jabs DA, Lightman SL, Thorne JE, Holbrook JT; Multicenter Uveitis Steroid Treatment (MUST) Trial Research Group. Factors predicting visual acuity outcome in intermediate, posterior, and panuveitis: the Multicenter Uveitis Steroid Treatment (MUST) trial. Am J Ophthalmol. 2015 Dec;160(6):1133-1141.e9. doi: 10.1016/j.ajo.2015.09.017. Epub 2015 Sep 18. PMID 26386159

Journal: American Journal Of Ophthalmology, Volume 160, Issue 6, Dec 2015

PURPOSE To identify factors associated with best-corrected visual acuity (BCVA) presentation and 2-year outcome in 479 intermediate, posterior, and panuveitic eyes.

DESIGN Cohort study using randomized controlled trial data.

METHODS Multicenter Uveitis Steroid Treatment (MUST) Trial masked BCVA measurements at baseline and at 2 years follow-up used gold-standard methods. Twenty-three clinical centers documented characteristics per protocol, which were evaluated as potential predictive factors for baseline BCVA and 2-year change in BCVA.

RESULTS Baseline factors significantly associated with reduced BCVA included age ≥50 vs 10 vs grade 0; cataract; macular thickening; and exudative retinal detachment. Over 2 years, eyes better than 20/50 and 20/50 or worse at baseline improved, on average, by 1 letter (P = .52) and 10 letters (P 10 vs <6 years), incident AC flare, cataract at both baseline and follow-up, pseudophakia at baseline, persistence or incidence of vitreous haze, and incidence of macular thickening.

CONCLUSIONS Intermediate, posterior, and panuveitis have a similarly favorable prognosis with both systemic and fluocinolone acetonide implant treatment. Eyes with more prolonged/severe inflammatory damage and/or inflammatory findings initially or during follow-up have a worse visual acuity prognosis. The results indicate the value of implementing best practices in managing inflammation.

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