Intermedial uveitis: clinical course in ten years follow up

Abstract

Abstract Purpose: Intermedial uveitis (IU) is a chronic ocular disorder of unknown origin with frequent development of macular edema. The long term course of IU is not yet known and is a subject of this study Methods: Retrospective study of 28 patients with IU (12 males, 16 females; 49 affected eyes) in whom a follow up of at least 10 years starting with the onset of IU was available. Results: The average age at the onset of IU was 37. Five patients had an associated systemic disease (2 sarcoidosis and 3 multiple sclerosis). At onset bilateral involvement was observed in 20/28 (71%) patients. Visual acuity (VA) of more than 0.8 was noted in 19/48 (39%) affected eyes; and VA of less than 0.1 in 2/48 (4%) affected eyes. Systemic treatment with immunosuppressant drugs was required in 7/28 cases (25%) and 13 eyes underwent one or more surgical procedures (cataract surgery in 10 eyes, pars plana vitrectomy in 2 eyes, scleral buckling in 1 eye). At ten‐year follow‐up VA of more than 0.8 was noted in 22/49 (45%) affected eyes; and VA of less than 0.1 in 10/49 (8%) affected eyes. The causes of visual loss included predominantly cataract, macular edema and vitreous opacities. Moreover, during the ten‐year follow up intraocular inflammation diminished in 10/28 (36%) patients. The mean time to remission was 5.4 years (range 2‐12 years). During the follow up, systemic disease sarcoidosis and multiple sclerosis manifested in two additional patients. Conclusions: The main complication of IU consisted of cataract, followed by macular edema and vitreous opacities. Within ten‐year of follow‐up one third of patient with IU achieved the long‐term remission of the intraocular inflammation.