Incidence of and Risk Factors for Cataract in Anterior Uveitis
Copyright © 2023 Elsevier Inc. All rights reserved..
PURPOSE: To estimate the incidence/risk factors for cataract in noninfectious anterior uveitis.
DESIGN: Retrospective multicenter cohort study (6 US tertiary uveitis sites, 1978-2010).
METHODS: Data were harvested by trained expert reviewers, using protocol-driven review of experts' charts. We studied cataract incidence-newly reduced visual acuity worse than 20/40 attributed to cataract; or incident cataract surgery-in 3923 eyes of 2567 patients with anterior uveitis.
RESULTS: Cataract developed in 507 eyes (54/1000 eye-years, 95% CI 49-59). Time-updated risk factors associated with cataract included older age (≥65 vs <18 years: adjusted hazard ratio [aHR] 5.04, 95% CI 3.04-8.33), higher anterior chamber cell grade (P(trend)=0.001), prior incisional glaucoma surgery (aHR 1.86, 95% CI 1.10-3.14), band keratopathy (aHR 2.23, 95% CI 1.47-3.37), posterior synechiae (aHR 3.71, 95% CI 2.83-4.87), and elevated intraocular pressure ≥30 vs 6-20 mm Hg (aHR 2.57, 95% CI 1.38-4.77). Primary acute (aHR 0.59, 95% CI 0.30-1.15) and recurrent acute (aHR 0.74, 95% CI 0.55-0.98) had lower cataract risk than chronic anterior uveitis. Higher-dose prednisolone acetate 1%-equivalent use (≥2 drops/day) was associated with >2-fold higher cataract risk in eyes with anterior chamber cell grades 0.5+ or lower but was not associated with higher cataract risk in the presence of anterior chamber cells of grade 1+ or higher.
CONCLUSIONS: Cataract complicates anterior uveitis in ∼5.4/100 eye-years. Several fixed and modifiable risk factors were identified, yielding a point system to guide cataract risk minimization. Topical corticosteroids only were associated with increased cataract risk when anterior chamber cells were absent or minimally present, suggesting their use to treat active inflammation (which itself is cataractogenic) does not cause a net increase in cataract incidence.
| Errataetall: |
CommentIn: Am J Ophthalmol. 2023 Oct;254:A4-A6. - PMID 37393973 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:254 |
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| Enthalten in: |
American journal of ophthalmology - 254(2023) vom: 30. Okt., Seite 221-232 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Papaliodis, George N [VerfasserIn] |
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| Links: |
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Journal Article |
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| Anmerkungen: |
Date Completed 26.09.2023 Date Revised 11.10.2023 published: Print-Electronic CommentIn: Am J Ophthalmol. 2023 Oct;254:A4-A6. - PMID 37393973 Citation Status MEDLINE |
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| doi: |
10.1016/j.ajo.2023.06.021 |
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| 100 | 1 | |a Papaliodis, George N |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Incidence of and Risk Factors for Cataract in Anterior Uveitis |
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| 500 | |a Date Completed 26.09.2023 | ||
| 500 | |a Date Revised 11.10.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Am J Ophthalmol. 2023 Oct;254:A4-A6. - PMID 37393973 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a PURPOSE: To estimate the incidence/risk factors for cataract in noninfectious anterior uveitis | ||
| 520 | |a DESIGN: Retrospective multicenter cohort study (6 US tertiary uveitis sites, 1978-2010) | ||
| 520 | |a METHODS: Data were harvested by trained expert reviewers, using protocol-driven review of experts' charts. We studied cataract incidence-newly reduced visual acuity worse than 20/40 attributed to cataract; or incident cataract surgery-in 3923 eyes of 2567 patients with anterior uveitis | ||
| 520 | |a RESULTS: Cataract developed in 507 eyes (54/1000 eye-years, 95% CI 49-59). Time-updated risk factors associated with cataract included older age (≥65 vs <18 years: adjusted hazard ratio [aHR] 5.04, 95% CI 3.04-8.33), higher anterior chamber cell grade (P(trend)=0.001), prior incisional glaucoma surgery (aHR 1.86, 95% CI 1.10-3.14), band keratopathy (aHR 2.23, 95% CI 1.47-3.37), posterior synechiae (aHR 3.71, 95% CI 2.83-4.87), and elevated intraocular pressure ≥30 vs 6-20 mm Hg (aHR 2.57, 95% CI 1.38-4.77). Primary acute (aHR 0.59, 95% CI 0.30-1.15) and recurrent acute (aHR 0.74, 95% CI 0.55-0.98) had lower cataract risk than chronic anterior uveitis. Higher-dose prednisolone acetate 1%-equivalent use (≥2 drops/day) was associated with >2-fold higher cataract risk in eyes with anterior chamber cell grades 0.5+ or lower but was not associated with higher cataract risk in the presence of anterior chamber cells of grade 1+ or higher | ||
| 520 | |a CONCLUSIONS: Cataract complicates anterior uveitis in ∼5.4/100 eye-years. Several fixed and modifiable risk factors were identified, yielding a point system to guide cataract risk minimization. Topical corticosteroids only were associated with increased cataract risk when anterior chamber cells were absent or minimally present, suggesting their use to treat active inflammation (which itself is cataractogenic) does not cause a net increase in cataract incidence | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 700 | 1 | |a Rosner, Bernard A |e verfasserin |4 aut | |
| 700 | 1 | |a Dreger, Kurt A |e verfasserin |4 aut | |
| 700 | 1 | |a Fitzgerald, Tonetta D |e verfasserin |4 aut | |
| 700 | 1 | |a Artornsombudh, Pichaporn |e verfasserin |4 aut | |
| 700 | 1 | |a Kothari, Srishti |e verfasserin |4 aut | |
| 700 | 1 | |a Gangaputra, Sapna S |e verfasserin |4 aut | |
| 700 | 1 | |a Levy-Clarke, Grace A |e verfasserin |4 aut | |
| 700 | 1 | |a Nussenblatt, Robert B |e verfasserin |4 aut | |
| 700 | 1 | |a Rosenbaum, James T |e verfasserin |4 aut | |
| 700 | 1 | |a Sen, H Nida |e verfasserin |4 aut | |
| 700 | 1 | |a Suhler, Eric B |e verfasserin |4 aut | |
| 700 | 1 | |a Thorne, Jennifer E |e verfasserin |4 aut | |
| 700 | 1 | |a Bhatt, Nirali P |e verfasserin |4 aut | |
| 700 | 1 | |a Foster, C Stephen |e verfasserin |4 aut | |
| 700 | 1 | |a Jabs, Douglas A |e verfasserin |4 aut | |
| 700 | 1 | |a Pak, Clara M |e verfasserin |4 aut | |
| 700 | 1 | |a Ying, Gui-Shuang |e verfasserin |4 aut | |
| 700 | 1 | |a Kempen, John H |e verfasserin |4 aut | |
| 700 | 0 | |a Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Cohort Study Research Group |e verfasserin |4 aut | |
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