Uveitis patients treated with steroids and immunosuppressants more likely to develop cataract

A study was done to evaluate the rate of, risk factors for, and outcomes of cataract surgery in patients with intermediate, posterior, and panuveitides treated with systemic corticosteroids and immunosuppression.

Cohort study of participants from a Randomized Clinical Trial. Multicenter clinical trial with extended follow-up. Participants: Cohort of participants assigned to systemic therapy in the Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study. Study population: 125 phakic eyes of 74 patients with intermediate, posterior or panuveitides treated with systemic therapy. Main outcome measures: Cataract surgery and visual acuity after cataract surgery.

Results

The cumulative incidence of cataract surgery was 43% at 7-years of follow-up, and the risk did not plateau. Risk factors for cataract surgery included age >50 years (hazard ratio [HR] 2.86; 95% CI 1.52, 5.42; P=0.001), topical corticosteroid use (time-updated HR 3.13; 95% CI 1.42, 6.94; P=0.005), glaucoma medication use (HR 2.75; 95% CI 1.38, 5.47; P=0.004), and possibly history of anterior chamber inflammation (HR 1.90; 95% CI 0.95, 3.84; P=0.07). Median gain in acuity and median best corrected visual acuity 1-year after cataract surgery were 4.8 lines and 20/25, respectively, among 42 eyes undergoing cataract surgery with 1-year follow-up data.

Among patients with intermediate, posterior and panuveitides, treated with oral corticosteroids and immunosuppression, there is a substantial long-term risk of cataract surgery. Visual acuity outcomes after cataract surgery are generally good.

Reference:

Douglas A. Jabs, Elizabeth A. Sugar, Alyce E. Burke, Richard J. Stawell, Janet T. Holbrook. Cataract surgery in patients with uveitis treated with systemic therapy in the Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study: risk factors and outcomes. the Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study Research Group11

Published:July 03, 2023DOI:

https://doi.org/10.1016/j.ajo.2023.06.023

Keywords:

Patient, uveitis, treated, steroids, immunosuppressants, more, likely, develop, cataract, American Journal of Ophthalmology, Douglas A. Jabs, Elizabeth A. Sugar, Alyce E. Burke, Richard J. Stawell, Janet T. Holbrook