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 - Funding Information:
Funding/Support: Supported by National Eye Institute grant EY014943 (J.H.K.), Research to Prevent Blindness , Paul and Evanina Mackall Foundation , Lois Pope Life Foundation , Sight for Souls , Massachusetts Eye and Ear Global Surgery Program. J.H.K. was an RPB James S Adams Special Scholar Award recipient, J.E.T. was an RPB Harrington Special Scholar Award recipient, and D.A.J. and J.T.R. were Research to Prevent Blindness Senior Scientific Investigator Award recipients. G.A.L-C., R.B.N., and H.N.S. were supported by National Eye Institute. E.B.S. receives support from the Department of Veterans' Affairs. None of the sponsors had any role in the design and conduct of the report; collection, management, analysis, and interpretation of the data; or in the preparation, review, and approval of this manuscript.
Funding Information:
All authors have completed and submitted the ICMJE form for Disclosure of Potential Conflicts of Interest and none were reported. Funding/Support: Supported by National Eye Institute grant EY014943 (J.H.K.), Research to Prevent Blindness, Paul and Evanina Mackall Foundation, Lois Pope Life Foundation, Sight for Souls, Massachusetts Eye and Ear Global Surgery Program. J.H.K. was an RPB James S Adams Special Scholar Award recipient, J.E.T. was an RPB Harrington Special Scholar Award recipient, and D.A.J. and J.T.R. were Research to Prevent Blindness Senior Scientific Investigator Award recipients. G.A.L-C. R.B.N. and H.N.S. were supported by National Eye Institute. E.B.S. receives support from the Department of Veterans' Affairs. None of the sponsors had any role in the design and conduct of the report; collection, management, analysis, and interpretation of the data; or in the preparation, review, and approval of this manuscript. Financial Disclosures: C.S.F. owns equity in Eyegate; and is a consultant for Allergan, Bausch & Lomb, Sirion; and is a speaker for Allergan, Alcon, Inspire, Ista, and Centocor. J.H.K. is a consultant for Santen, Gilead; and is an advisory board member of Clearside. J.R. is a consultant for Abbvie, Roche, Janssen, Gilead, Santen, UCB, Novartis, Eyevensys; and has received grants from Pfizer and royalty from UpToDate. J. E.T. is a consultant for AbbVie, Gilead, Nightstar; and is a member of the advisory board for Clearside; and has received grants from Allergan, NEI, and Santen. E.B.S. is a consultant for and has received research support from Abbvie, Clearside, EyeGate, EyePoint, Gilead, Eyevensys, Santen, Bristol Meyers Squibb, and Genentech. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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.
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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 -