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Incidence of and Risk Factors for Cataract in Anterior Uveitis

2023; Elsevier BV; Volume: 254; Linguagem: Inglês

10.1016/j.ajo.2023.06.021

1879-1891

George N. Papaliodis, Bernard Rosner, Kurt Dreger, Tonetta D. Fitzgerald, Pichaporn Artornsombudh, Srishti Kothari, Sapna Gangaputra, Grace A. Levy-Clarke, Robert B. Nussenblatt, James T. Rosenbaum, H. Nida Sen, Eric B. Suhler, Jennifer E. Thorne, Nirali Bhatt, C. Stephen Foster, Douglas A. Jabs, Clara M. Pak, Gui‐Shuang Ying, John H. Kempen,

Retinal and Optic Conditions

PURPOSETo estimate the incidence/risk factors for cataract in noninfectious anterior uveitis.DESIGNRetrospective multicenter cohort study (6 US tertiary uveitis sites, 1978-2010).METHODSData 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.RESULTSCataract developed in 507 eyes (54/1000 eye-years, 95% CI 49-59). Time-updated risk factors associated with cataract included older age (≥65 vs 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.CONCLUSIONSCataract 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. To estimate the incidence/risk factors for cataract in noninfectious anterior uveitis. Retrospective multicenter cohort study (6 US tertiary uveitis sites, 1978-2010). 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. 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 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. 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.