Impact of Anterior Uveitis on Patients: 5 Year Prognosis from the DUET Study

Introduction

Anterior uveitis (AU) is the the most common form of uveitis of which autoimmunity is one of the primary causes.(1, 2) This includes idiopathic AU or those associated with HLA-B27 polymorphism and spondyloarthropathy (SpA) The DUET study formalised an early detection and referral algorithm for AU patients who had previously undiagnosed SpA.

Aims

To review patients who were first diagnosed in the DUET study 5 years ago, and better understand the nature of AU and its impact on quality of life.

Methods

This is a cohort study examining the natural history of AU. All patients (n=96) who were ‘first presenters’ from the DUET study were invited. During the outpatient appointment, a standardised ocular history and examination together with quality of life survey with the SF36 and VCM1 questionnaire were completed. Basic descriptive statistical analysis for epidemiological data was conducted with univariable and multivariable analysis to identify clinical predictors which may affect quality of life, visual acuity, cataract and glaucoma development in the long term.

Results

41% (n=39) of patients attended the appointment. SF36 scores were above average in all patients (PCS= 72.9± 21.52, MCS= 74.52±22.70) and no clinical predictors identified. Patients of Irish heritage tend to have better VCM1 score (coefficient =-1.4, CI=-2.5 to -0.29, p=0.01). Male patients (coefficient=-0.08, CI=-0.15 to 0, p=0.05) and patients with HLA-B27 positive (coefficient=-0.08, CI=-0.17 to 0, p=0.04) have better visual acuity of 4 letters. 42% of patients had cataract development of which main risk factor is age (OR=1.3, CI=1.07 to 1.57 p

Conclusions

The long-term prognosis of anterior uveitis is very reassuring as quality of life and ocular outcomes are above average. This study also highlights the importance of diagnosing SpA early as it is able to provide a quality of life similar to those without SpA