METHODS: Charts between January 1997 and December 2010 were retrospectively reviewed. Charts between January 2014 and December 2014 were prospectively reviewed.
RESULTS: A total of 1249 and 148 charts were retrospectively and prospectively reviewed, respectively. The top causes of anterior uveitis (AU) were HLA-B27, idiopathic, and CMV AU. The top known causes of intermediate uveitis were tuberculosis, primary intraocular lymphoma, and sarcoidosis. The top causes of posterior uveitis were CMV retinitis, toxoplasmosis, and dengue maculopathy. The top causes of panuveitis were VKH, idiopathic panuveitis, tuberculosis, and Behçet disease. HLA-B27 and CMV AU were more frequent among Chinese (21% vs 9% (non-Chinese); p<0.001; 10% vs 5% (non-Chinese); p<0.001, respectively). Tuberculous uveitis was more frequent among Malays and Indians (12% (non-Chinese) vs 5% (Chinese), p<0.001).
CONCLUSIONS: Different uveitis patterns were encountered among patients of different races.
CONCLUSION: Optic nerve infiltration in systemic metastatic retinal lymphoma may have initial occult signs but with profound visual loss. Ocular infections like CMV retinitis and tuberculosis may mask and delay the diagnosis in immunocompromised patients.
DESIGN: Retrospective study.
METHODS: Patients with uveitic CME were identified from the Inflammatory Eye Disease database. 248 eyes of 218 patients with uveitic CME were identified. Main Outcome Measures: Time to resolution, time to recurrence and vision loss.
RESULTS: Median age at time of CME was 51.7 years [IQR 37.3-63.9]. Overall likelihood of resolution was 209/248 eyes (85.3%). Resolution occurred in 34.1% with topical therapy, 69.2% treated with oral prednisone (72.9% if prednisone dose ≥ 60 mg/day), 73.5% treated with orbital floor steroid, and 86.7% treated with intravitreal steroid. On multivariate analysis, ERM was associated with decreased resolution of CME (HR 0.735 p = 0.045). Additionally, infectious aetiology approached significance (HR 0.635 p = 0.059) for CME resolution. Recurrence occurred in 85 eyes (36.5%). Predictors of increased likelihood of recurrence were current smoking status (HR 1.818 p = 0.042) and subretinal fluid at diagnosis (HR 1.577 p = 0.043). Eyes with infectious aetiology had lower chance of CME resolution, but those that did resolve had lower probability of recurrence (HR 0.891 p = 0.019). Moderate vision loss (20/50-20/200) occurred in 24 eyes (9/7%) and severe vision loss (≤20/200) in 17 eyes (6.9%).
CONCLUSIONS: Management of CME is challenging given the heterogeneous aetiologies, severity of the macular edema as well as response to the therapy. A high rate of resolution was observed, given sufficient time, but recurrence occurs in one-third. Current smoking status plays an important role in the risk of recurrence of CME and patients should be encouraged to stop smoking.