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AmericanUveitisSocietySpringMeeting2015
chairedby
TammyM.Martin,PhDCaseyEyeInstitute,OHSU&DeversEyeInstitute,LRI
Rooms708/710/712,ColoradoConventionCenter
2May,2015
Program
5.00PM
SocialHour(Room703)
6.00PM
PlenarySession:BasisforandUsesofBiologicDrugsinUveitis
RachelCaspi,PhD
NationalEyeInstitute,NationalInstitutesofHealth
“MirroringtheClinicalandImmunologicalComplexityofAutoimmuneUveitisin
AnimalModels”
EricB.Suhler,MD,MPH
OregonHealth&ScienceUniversity,VAPortlandHealthCareSystem
“BiologicWarfareonUveitis:PerspectivesfromtheClinic”
7.00PM
BusinessMeeting 7.30PM
Freepapers
7.30PM
GaryHolland,MD:InteractionbetweenKillerImmunoglobulin-like
Receptor(KIR)Gene-HLACombinationsandParasiteSerotypesamong
HispanicIndividualsatRiskforOcularToxoplasmosis
7.45PM
DouglasA.Jabs,MD,MBA:Long-termOutcomesofCytomegalovirus
RetinitisintheUnitedStatesintheEraofModernAntiretroviral
Therapy
8.00PM
JohnA.Gonzales,MD:QualityofLifeOutcomesfromaRandomized
ClinicalTrialforNoninfectiousIntermediate,Posterior,andPan-
Uveitis
1
8.15PM
8.30PM
8.45PM
9.00PM
9.15PM
9.30PM
AliK.Tayyeba,MD:ManagementofEndStageCornealDiseaseand
ChronicUveiticHypotonybyCombiningtheBostonType1
KeratoprosthesiswithParsPlanaVitrectomyandSiliconeOilFill
DanielLFeiler,MD:TreatmentofUveiticCystoidMacularEdema
withTopicalDifluprednate.
LauraJ.Kopplin,MD:Peginterferonalfa-2a(PEGASYS)inthe
TreatmentofInflammatoryCystoidMacularEdema
BlakeA.Isernhagen,MD:AutoimmuneRetinopathy:AGuidefor
CliniciansBasedonRecommendationsofanExpertPanel
SarjuS.Patel,MD:TheUtilityandLimitationsofWide-Field
AutofluorescenceinInflammatoryChoroiditis
FriederikeMackensen,MD:IsThereaCorrelationBetweenMultiple
SclerosisandFuchsUveitis
2
ABSTRACTS
InteractionbetweenKillerImmunoglobulin-likeReceptor(KIR)Gene-HLACombinations
andParasiteSerotypesamongHispanicIndividualsatRiskforOcularToxoplasmosis
Authors
GaryN.Holland,1ADavidC.Reed,1AChristianJ.Sanfilippo,1AFeiYu,1AJeffreyL.Jones,2PatrickA.
Coady,3LeanneT.Labriola,4Ann-MarieLobo,5YingQian,6JoseG.Montoya,7MichaelE.Grigg,8Raja
Rajalingam,1BandtheNorthAmericanOcularToxoplasmosisStudyGroup.
AuthorAffiliations
A OcularInflammatoryDiseaseCenter,SteinEyeInstituteandDepartmentofOphthalmology.
B ImmunogeneticsLaboratory,DepartmentofPathologyandLaboratoryMedicine.
1 DavidGeffenSchoolofMedicineatUCLA,LosAngeles,CA.
2 ParasiticDiseaseBranch,DivisionofParasiticDiseasesandMalaria,CenterforGlobalHealth,
CentersforDiseaseControlandPrevention,Atlanta,GA.
3 DartmouthMedicalSchool,Lebanon,NH.
4 DepartmentofOphthalmology,UniversityofSouthernCalifornia,LosAngeles,CA.
5 MassachusettsEyeandEarInfirmary,HarvardMedicalSchool,Boston,MA.
6 FrancisI.ProctorFoundationandDepartmentofOphthalmology,UCSanFrancisco,San
Francisco,CA.
7 DepartmentofImmunologyandInfectiousDiseases,StanfordUniversitySchoolofMedicine,
Stanford,CA.
8 MolecularParasitologyUnit,LaboratoryofParasiticDiseases,NIAID,NIH,Bethesda,MD.
Abstract
Purpose:Toinvestigaterelationshipsbetweenoculartoxoplasmosisandthefollowingfactors
amongT.gondii-infectedHispanics:killerimmunoglobulin-likereceptor(KIR)genes;HLAtypes;
KIR/HLAcombinations;andparasiteserotypes.WealsosoughtevidenceofKIR/HLAcombinationserotypeinteractions.
Methods:Weevaluated88T.gondii-infectedHispanicadultswhodid(n=37)ordidnot(n=51)
havetoxoplasmicretinochoroiditis.SerotypesweredeterminedwithanELISAthatidentifiedhost
antibodiesagainst8peptidesassociatedwithgenotype-specificalleles.Oddsratios(ORs)forocular
involvementamongthosewithnon-TypeIIinfectionsvs.thosewithTypeIIinfectionswere
calculatedforsubgroupswithandwithoutvariousKIR/HLAcombinations.TheBreslow-Daytest
forhomogeneityofORsbetween2groupswasusedtoidentifyinteractionsbetweenKIR/HLA
combinationsandserotype.
Results:OcularinvolvementwasnotsignificantlyassociatedwithserotypeoranyKIRgenein
crudeanalyses.Ocularinvolvementwasassociatedwiththefollowingfactors:HLAtypesA68
(p=0.0002),B39(p=0.011),B65(p=0.038),andC06(p=0.011);HLAGroupC1(p=0.0006);and
KIR/HLAcombinationKIR2DL2/2DL3/HLA-C1(p=0.0006).Thereappearedtobeinteractions
betweenserotypeandatleast6of10KIR/HLAcombinationschosenprospectivelyfortesting.
Regardingriskofocularinvolvementwithnon-TypeIIinfections,eachof4KIR/HLAcombinations
wasassociatedwithincreasedriskofocularinvolvement,whileabsenceofeachofthesame
combinationswasassociatedwithdecreasedrisk.Thereversewasobservedfor2KIR/HLA
combinations.
3
Conclusion:HostfactorscaninfluenceriskofocularinvolvementamongT.gondii-infected
individuals,evenwithoutevidenceofimmunedysfunction.Parasitevirulencelikelydependson
interactionsofhostandparasite-derivedgeneproducts,asdemonstratedinanimalmodels.Study
oftheseinteractionsmayprovideinsightintooculardiseasepathogenesis.
ThisresearchisNOTaclinicaltrial.
Disclosure(s)
None
Support
ResearchtoPreventBlindness,Inc,NewYork,NY(Dr.Holland);CentersforDiseaseControland
Prevention,Atlanta,GA(Drs.Holland,Jones);theSkirballFoundation,NewYork,NY(Dr.Holland),
theAltaCaliforniaEyeResearchFoundation,SanFrancisco,CA(Dr.Sanfilippo),andtheIntramural
ResearchProgramoftheNationalInstitutesofHealth,NIAID(Dr.Grigg).Dr.GriggisaScholarofthe
CanadianInstituteforAdvancedResearch(CIFAR)IntegratedMicrobialBiodiversityProgram.
4
Long-termOutcomesofCytomegalovirusRetinitisintheUnitedStatesintheEraofModern
AntiretroviralTherapy
Authors
Jabs,Douglas;AhujaAlka;VanNatta,Mark;Lyon,Alice;Yeh,Steven;Danis,Ron
AuthorAffiliations
FromtheDepartmentsofOphthalmologyandMedicine,theIcahnSchoolofMedicineatMount
Sinai;theCenterforClinicalTrials,theDepartmentofEpidemiology,TheJohnsHopkinsUniversity
BloombergSchoolofPublicHealth;theDepartmentofOphthalmology,theNorthwesternUniversity
FeinbergSchoolofMedicine;theDepartmentofOphthalmology,theEmoryUniversitySchoolof
Medicine;andtheDepartmentofOphthalmology,theUniversityofWisconsin,Madison.
Abstract
PURPOSE:Todescribethelong-termoutcomesofpatientswithcytomegalovirus(CMV)retinitis
andtheacquiredimmunodeficiencysyndrome(AIDS)intheeraofmoderncombination
antiretroviraltherapy(ART).
METHODS:Prospective,observational,UnitedStatescohortof479patientswithAIDSandCMV
retinitisdiagnosedintheeraofmodernART.Patientswerecategorizedasimmunerecovered,
definedasaCD4+Tcellcount>100cells/µLfor>3months,ornot.Outcomesincludedmortality,
visualimpairment(visualacuityworsethan20/40),blindness(visualacuity20/200orworse),and
lossofvisualfieldonquantitativeGoldmannperimetry.
RESULTS:Patientswithoutimmunerecoveryhadamortalityof44.4/100person-years(PY),anda
mediansurvivalof13.5monthsafterthediagnosisofCMVretinitis,whereasthosewithimmune
recoveryhadamortalityof2.7/100PY,andanestimatedmediansurvivalof27.0years.Therates
ofbilateralvisualimpairmentandblindnesswere0.9/100PYand0.4/100PY,respectively,anddid
notdifferbyimmunerecoverystatus.Ratesofvisualfieldlosswere7%ofthenormalfield/year
forthosewithoutimmunerecoveryand1%/yearforthosewithimmunerecovery.
CONCLUSIONS:AmongpersonswithAIDSandCMVretinitis,long-termsurvivalispossible,ifthere
isimmunerecovery.Ifthereisnoimmunerecovery,themortalityrateissubstantialandsimilarto
thepre-modernARTera.Althoughlow,theratesofbilateralvisualimpairmentandblindnessare
greaterthanthoseseeninanHIV-uninfectedpopulation.
ThisresearchisNOTaclinicaltrial.
Disclosure(s)
None
Support
NEIcooperativeagreementsU10EY08052,U10EY08057,U10EY08067.
5
QualityofLifeOutcomesfromaRandomizedClinicalTrialforNoninfectiousIntermediate,
Posterior,andPan-Uveitis
Authors
Gonzales,JohnA.,MD1,5Rathinam,SivakumarR.,MD,PhD2,Babu,Manohar,MD3,Thundikandy,
Radhika,MD2,Kanakath,Anuradha,MD3,Browne,EricaN.,MS1,Acharya,NishaR.,MD,MS1,4,5
AuthorAffiliations
Institutions:1F.I.ProctorFoundation,UniversityofCalifornia,SanFrancisco;2AravindEyeCare
System,Madurai,India;3AravindEyeCareSystem,Coimbatore,India;4Departmentof
Epidemiology&Biostatistics,UniversityofCalifornia,SanFrancisco;5Departmentof
Ophthalmology,UniversityofCalifornia,SanFrancisco
Abstract
Purpose:Toevaluatequalityoflife(QOL)changesinpatientstreatedwithmethotrexate(MTX)or
mycophenolatemofetil(MMF)fornon-infectiousintermediate,posterior,orpan-uveitis.
Methods:Thisisasecondaryanalysisfromaclinicaltrialof80patientsenrolledinarandomized
observer-maskedtrialtocomparetheeffectivenessofMTXvs.MMF.Patientsreceivedsystemic
corticosteroidswhichweretaperedaccordingtoSUNguidelines.PatientswereenrolledatAravind
EyeHospitalinIndiaandfollowedmonthlyfor6months.Themainoutcomewastheproportionof
patientsachievingcorticosteroid-sparingcontrolofinflammation.QOLmeasurementswere
collectedatbaselineandatthefinalstudyvisitusingtheIndianVisionFunctionQuestionnaire
(IND-VFQ33)andtheShortFormHealthSurvey(SF-36).T-testswereusedtocomparechangesin
scoresandFishersexacttestwasusedtocompareproportions.
Results:67patientswithcompletefollow-upwereincludedintheanalysis.Overall,theIND-VFQ33
compositescoreimprovedbyanaverageof9.7points(95%confidenceinterval(CI):5.6,13.9,
p<0.001).Therewasnostatisticallysignificantdifferenceinimprovementbytreatmentgroup
(p=0.86).TheVFQcompositescoreimprovedfor97%oftreatmentsuccessescomparedto68%of
treatmentfailures(p=0.001).Ingeneral,therewasnosignificantchangeintheSF-36physical
componentsummaryscore(p=0.58),buttherewasaslightdecreaseinthementalcomponent
summaryscore(meanchange-1.8points,95%CI:-3.8,0.1p=0.07).Thiswasmainlyduetoa
decreaseinthevitalitydomain(meanchange-3.2points,95%CI:-5.3,-1.2,p=0.002).
Conclusions:Vision-relatedQOLimprovedwithimmunosuppressanttreatment.Therewas
consistentimprovementinthosewhowereatreatmentsuccessandresultsweremixedfor
treatmentfailures.Therewasnochangeinthephysicalcomponentofgeneralhealth,buttherewas
asignificantdecreaseinvitalityinbothtreatmentgroups.
ThisresearchISaclinicaltrialandisregisteredatwww.clinicaltrials.gov.
Disclosure(s)
None
Support
FundingforthistrialwasprovidedbyThatManMaySeeandTheSouthAsiaResearchFund.
6
ManagementofEndStageCornealDiseaseandChronicUveiticHypotonybyCombiningthe
BostonType1KeratoprosthesiswithParsPlanaVitrectomyandSiliconeOilFill
Authors
TayyebaK.Ali,MD,1GuillermoAmescua,MD,1AllisterGibbons,MD,1VictorL.Perez,MD1,JanetL.
Davis,MD,1
AuthorAffiliations
1DepartmentofOphthalmology,BascomPalmerEyeInstitute,UniversityofMiamiMillerSchoolof
Medicine;Miami,FL.
Abstract
PURPOSE:
ToreviewtheoutcomesofBostontype1keratoprosthesis(B-KPro)implantationincombination
withparsplanavitrectomyandsiliconeoilforthetreatmentofendstagebullouskeratopathyand
uveitichypotony.
METHODS:
Thiswasaretrospectivechartreview.Sixeyesof5patientsunderwentB-KProimplantation,pars
planavitrectomy,andsiliconeoilplacement.Allpreoperativecharacteristics,includingvisual
acuityandintraocularpressure,intraoperativeevents,andpostoperativeoutcomeswereanalyzed.
RESULTS:
Meanpatientagewas63.9years(range40.9-86.4years).Meanpre-operativeBCVAwaslogMAR
2.73(range2.60to3.00).Initially,againofvisualacuitywasseeninhalfthesamplewithmean
BCVAlogMAR1.90(Range0.90to3.00).Atfinalfollow-up(mean25.8monthsandrange12to52
months),meanvisualacuitywaslogMAR2.23(range1.20to3.00)andnoeyelostvision.Twoeyes
(33%)hadpreviouslyundergonecornealtransplantation,oneofwhichwasanendothelial
keratoplasty(DSAEK).Theother4eyeshadaB-Kproastheirfirstcornealprocedure.No
intraoperativecomplicationsoccurred,thoughonepatienthadaconcomitantretinaldetachment
(RD)repairforpre-existingRD.B-KProretentionratewasonehundredpercent.Onepatient
developedaretroprostheticmembrane(RPM);nopatientsexperiencedcomplicationssuchasmelt,
endophthalmitis,orextrusion.TheonepatientwhohadanRPMhadapsuedophakicB-Kpro,which
mayhavecontributedtopersistenceofRPM.Therewerenouveiticflaresandhypotonywas
controlled,thoughfurtherintervention,includingrepeatSOfillinonepatient,wasrequiredover
theextendedfollow-upofthesepatients.
CONCLUSIONS:
B-KProimplantationincombinationwithparsplanavitrectomyandintraocularsiliconeoilfillisa
safe,thoughend-stage,procedurethatmaintainscontrolofuveitis,canimprovevisioninsome
chronicallyhypotonouseyes,andmaydelayorpreventphthisis.
ThisresearchisNOTaclinicaltrial.
Disclosure(s)
None
Support
None
7
TreatmentofUveiticCystoidMacularEdemawithTopicalDifluprednate.
Authors
Feiler,DanielL;Srivastava,SunilK;Lowder,CareenY
AuthorAffiliations
ClevelandClinic,ColeEyeInstitute
Abstract
Purpose:Cystoidmacularedema(CME)isacommoncauseofvisionlossinpatientswithuveitis.
Evidenceforoptimaltreatmentstrategiesislacking.Thepotency,limitedsystemicabsorption,and
non-invasivenatureoftopicaldifluprednatemakeitanattractivetreatmentoptionwhencompared
totraditionalornoveltreatments.Weretrospectivelyreviewedtheefficacyofdifluprednate
ophthalmicemulsion0.05%inthetreatmentofCMEinpatientswithuveitis.
Methods:Twentytwoeyesof18patientswithuveiticCMEtreatedwithtopicaldifluprednatefour
timesdailyfor3weeksandtaperedover1monthwerereviewedforbest-correctedSnellenvisual
acuity(VA),centralfovealthickness(CFT)onopticalcoherencetomography(OCT),andintraocular
pressure(IOP).Amixedmodelwasfitwitheachmeasureastheoutcome,andvisittimeasthe
primarypredictor,withpatientandeyeasrandomeffects.AnalyseswereperformedusingSAS
software(version9.3;Cary,NC).Asignificancelevelof0.05wasassumedforalltests.
Results:Twentytwo(100%)eyeshadadecreaseinCFTatfollow-up.MeanCFTdecreasedby
121μm(P<0.001)at30days±15days(21eyes),and137um(p<0.001)at60days±15days(12
eyes).Sixof21(28%)eyeshadcompleteresolutionofIRFat30days±15days,while8of12(66%)
hadcompleteresolutionofIRFat60days±15days.LogMARVAimprovedbyameanof0.160
(P=0.013)andVAimprovedbyatleast1linein9of12eyes(75%)(P=0.013)at60days±15days.
MeanincreaseinIOPwas2.0mmHgat30days±15days(P=0.040)and2.2mmHgat60days±15
days(P=0.086).Nosignificantocularorsystemicadverseeffectswereobserved.
Conclusions:Theseresultssuggestthattopicaldifluprednateisawell-toleratedandeffective
treatmentforuveiticCMEwithdecreasedOCTCFT,mildimprovementinVA,andmildelevationof
IOPinthestudiedpatients.FurtherevaluationoftopicaldifluprednateforuveiticCMEincontrolled
randomizedstudiesiswarranted.
ThisresearchisNOTaclinicaltrial.
Disclosure(s)
DanielFeiler(none),SunilSrivastava(Alcon,Allergan,BauschandLomb),CareenLowder(None)
Support
None
8
Peginterferonalfa-2a(PEGASYS)intheTreatmentofInflammatoryCystoidMacularEdema
Authors
Kopplin,LauraJ.[1];Stiefel,HillaryC.[1];Vegunta,Sravanthi[2];Albini,ThomasA.[2];Suhler,Eric
B.[1,3]
AuthorAffiliations
[1]CaseyEyeInstitute,Portland,OR
[2]BascomPalmerEyeInstitute,Miami,FL
[3]VAPortlandHealthCareSystem,Portland,OR
Abstract
Purpose:Toassesstheutilityofpeginterferonalfa-2a(PEGASYS)inthetreatmentofrefractory
inflammatorycystoidmacularedema(CME).
Methods:Weconductedaretrospectivechartreviewoffourpatientswithrecalcitrant
inflammatoryCMEtreatedwithpeginterferonalfa-2aatthePortlandVAHealthCareSystemand
BascomPalmerEyeInstitute.
Results:ThreepatientshadCMEsecondarytochronicbilateralidiopathicanteriorand
intermediateuveitisandonepatienthadprimaryidiopathicCMEwithoutaknownhistoryof
uveitis.Allpatientsfailedmultipletreatmentregimenswithlocaland/orsystemictherapiesprior
toinitiationoftreatmentwithpeginterferonalfa-2a.Peginterferonalfa-2atherapyresultedin
improvementincentralmacularthickness(CMT)inallpatients(averageCMTwas475μmpretreatment(range304-752),279μmpost-treatment(range204-373),Wilcoxonsigned-ranktest
p<0.05)andresolutionofcysticintraretinalfluidinallcases.Visualacuityimprovedinthe
majorityofpatients;onepatienthadsignificantpreexistingphotoreceptoratrophylimitingvisual
recovery.Fatigueandflu-likesymptomsoccurredinthreepatientsandresultedintwopatients
electingtodiscontinuetherapywithresultantrecurrenceofCME.
Conclusions:Peginterferonalfa-2aisaneffecttreatmentforrefractoryinflammatoryCME,although
sideeffectsmaylimitpatienttolerability.
ThisresearchisNOTaclinicaltrial.
Disclosure(s)
Nonerelevanttothispresentation
Support
UnrestrictedinstitutionalgranttotheCaseyEyeInstitutefromResearchtoPreventBlindness,
DepartmentofVeteransAffairs(Dr.Suhler).
9
AutoimmuneRetinopathy:AGuideforCliniciansBasedonRecommendationsofanExpert
Panel
Authors
BlakeA.Isernhagen,MD1,HassanA.Aziz,MD1,LuciaSobrin,MD2,StevenK.Lundy,PhD3,JohnR.
Heckenlively,MD3,DebraA.Goldstein,MD4,ThiranJayasundera,MD3,JanetL.Davis,MD1
AuthorAffiliations
1DepartmentofOphthalmology,BascomPalmerEyeInstitute,UniversityofMiami,MillerSchoolof
Medicine,Miami,FL;2DepartmentofOphthalmology,MassachusettsEyeandEarInfirmary,
HarvardMedicalSchool,Boston,MA;3DepartmentofOphthalmology,KelloggEyeCenter,
UniversityofMichiganMedicalSchool,AnnArbor,MI;4DepartmentofOphthalmology,
NorthwesternUniversityFeinbergSchoolofMedicine,Chicago,IL
Abstract
Purpose:Toprovideclinicianswithguidanceindiagnosingandinterpretingancillarytesting,
proposingdifferentmodalitiesoftreatmentdependingonthediseaseseverity,andorganizingthe
follow-upcareofpatientswithnon-paraneoplasticautoimmuneretinopathy(np-AIR).
Methods:Physiciansandimmunologistswithexperienceinthediagnosisofnp-AIRconvenedatthe
BascomPalmerEyeInstitute.Thepanelreviewedavailableliteratureandcasepresentationsof
presumptivenp-AIRcollectedfromtertiaryuveitispractices.Afterroundtablediscussions,a
writinggroupagreedtosummarizetheopinionsofthegroupregardingidentificationofcases,
selectionofancillarytestsandevaluationofproposedtreatmentsbasedonthecurrentstateof
knowledgeandthecurrentmanagementpracticesintertiarycaresubspecialtyclinics.
Results:Recommendationsweremaderegardingtheutilityandinterpretationofthepatient’spast
medicalhistoryandsymptoms,clinicalexamfindings,andancillarytestingtohelpdiagnosisand
distinguishnp-AIRfromparaneoplasticretinopathyandretinaldegenerations.Ancillarytesting
includeselectroretinography,fundusautofluorescence,opticalcoherencetomography,fluorescein
angiography,evaluationforanti-retinalantibodies,andscreeningforsystemicmalignancy.In
slowlyprogressivesuspectednp-AIRthetreatmentisusuallyimmunosuppression.Inrapidly
progressivedisease,intravenouscorticosteroids,plasmapharesis,andintravenous
immunoglobulinsaresometimesused.Thereisnoproventherapy.Thedisappearanceof
antibodiesbywestern-blotafter6monthsoftreatmentsuggeststhatsufficienttreatmenthasbeen
given,butdeterminingthebenefitsoftreatmentremainsdifficultbecausevisualfunctionrarely
improves.
Conclusions:Theobservationsandrecommendationsfromthepanelhelpcliniciansdiagnoseand
treatpatientswithnp-AIR.Italsoservesasaplatformforfurtherresearchinthisfield.
ThisresearchisNOTaclinicaltrial.
Disclosure(s)
NONE
Support
NONE
10
TheUtilityandLimitationsofWide-FieldAutofluorescenceinInflammatoryChoroiditis
Authors
Patel,SarjuS
AuthorAffiliations
WeillCornellMedicalCollege
Abstract
PURPOSE:Toreportontheusefulnessofwide-fieldfundusautofluorescence(FAF)intheclinical
evaluationandmanagementofinflammatorychoroiditis
METHODS:Retrospectivecase-series
RESULTS:FAFimagingwasevaluatedin15casesofinflammatorychoroiditis,includingbothpan-
andposterioruveitisentities.FindingsonFAFwerepresentin14of15cases.However,these
findingswerenotfoundtobeusefulintheclinicalmanagementofthesepatientsbeyondfindings
onotherimagingmodalities(opticalcoherencetomography,angiography,andcolorfundus
photography)in10of15cases,whichincludedallpatientswithVKHsyndromeandbirdshot
chorioretinopathy.FAFwashelpfulinpatientswithidiopathicchoroiditisandvariantsofacute
zonaloccultouterretinopathy,withsubtlefindingscorrelatingwithvisualfielddefectsand
subjectivevisualchanges,whichdictatedchangesinclinicalmanagement.
CONCLUSIONS:WhileFAFfindingsarepresentinmostcasesofchoroiditis,FAFisclinicallyuseful
inasubsetofpatientswherechangescancorrelatewithvisualfielddefectsandhelpdictatethe
managementofthepatient.
ThisresearchisNOTaclinicaltrial.
Disclosure(s)
None
Support
None
11
IsThereaCorrelationBetweenMultipleSclerosisandFuchsUveitis?
Authors
Mackensen,Friederike;Kansupada,Kashyap;Zamir,Ehud
AuthorAffiliations
InterdisciplinaryUveitisCenterUniversityofHeidelberg,Germany
CharlotteEyeEarNose&ThroatAssociates,P.A.,USA
RoyalVictorianEyeandEarHospitalMelbourne,Australia
Abstract
Purpose:MembersoftheAmericanUveitisSocietydiscussedtheirobservationthatpatientswith
MultipleSclerosis(MS)maypresentwithFuchsUveitis(FUS)whichseemedtobemoreoften
bilateral.FUSissupposedtobecausedbyrubellainfectionandinMSaviralpathogenesishasbeen
discussedaswell.Acorrelationwashypothesized.
Methods:Retrospectivedatabasereviewofonecenter.AllpatientswithFUS,allpatientswithMS
andthosewithbothdiagnosesweresearchedforandevaluatedforanatomiclocalization,laterality
andinthosepatientswithbothdiagnosesalsoforvisualaccuity,complicationsanddetailsof
uveitispresentation.Additionalpatientswithbothdiagnosesfromothercenterswereadded.
Results:Inthedatabase289patientswerelistedwithFUS,194withMSand4withbothdiagnoses.
Thus,2%ofMSpatientshadFUSand1.4%ofFUSpatientshadMS.Additionally,5morepatients
withbothdiagnoseswereadded,sowehadacaseseriesof9patientswithMSandFUS.Bilateral
uveitiswasseenin11%ofFUSand33%ofFUS/MS.AllFUS/MShadstellatekeraticprecipitates
and7cataract,6hadheterochromia,3of3testedhadrubellaantibodiesinaqueoushumorand2
hadsecondaryglaucomawith1requiringsurgery.Medianageatdiagnoseswas31and28forMS
andFUS,respectively,and67%werefemale.
Conclusion:MSoccurrsinaproximately0.2%ofthepopulation,FUSin0.05%.Thereforethe
coincidenceofFUSandMSseemstobeslightlyhigherthantobeexpected.Ifthisisduetoahigher
susceptibilitytorubellathroughMSorevenapathogeneticlinktorubellainMSremains
speculative.
ThisresearchisNOTaclinicaltrial.
Disclosure(s)
None
Support
None
12