Patients with Noninfectious Uveitis May Be Spared from AMD, Study Shows

Ellen Kurek

Uveitis patients age ≥55 years are less likely to have large drusen than others.

In a retrospective cohort study of nearly 200 uveitis patients, H. Nida Sen, MD, and colleagues at the National Eye Institute (NEI) in Bethesda, MD, identified large drusen in only four of 170 patients, or 2.4% (95% confidence interval (CI), 0.6—6.0). Moreover, none of the uveitis patients whose electronic medical records and photographic data they reviewed had late-stage age-related macular degeneration (AMD).

The study included 177 patients with primary noninfectious uveitis who were seen at the NEI from 2004 through August, 2013, and who were at least 55 years old. However, only 170 of the 177, or 96%, had fundus photographs that were gradable.

The average patient age for the group as a whole was 65 ± 7.5 years (range, 55—87 years). The racial/ethnic composition of the study group included 87 non-Hispanic whites, 66 non-Hispanic blacks, six Hispanic whites, and 11 patients of other race or ethnicity.

The investigators determined that these uveitis patients also had age-related macular degeneration if either eye had large drusen, geographic atrophy, or neovascular AMD by Eye Diseases Prevalence Research Group (EDPRG) definitions.

They also used EDPRG estimates to determine how many cases of large drusen should be expected in these patients and to estimate the standardized mortality ratio related to cases with large drusen.

After comparing their findings with this estimate, the investigators concluded that large drusen appeared to be less prevalent in the patients they evaluated than in the general US population, even after they accounted for differences in the distribution of large drusen by patient age.

This lower prevalence was especially noticeable in non-Hispanic white patients. However, the investigators warned that the racial and sex make-up of their study population was not strictly equivalent to those of the general US population.

In addition, the investigators found that the standardized mortality ratio related to cases with large drusen was 0.32 (CI, 0.12—0.70) for the study group as a whole, 0.28 (CI, 0.09–0.79) for non-Hispanic whites, and 0.46 (CI, 0.14–1.29) for non-Hispanic blacks.

“Results of this study suggest possible sparing of patients with uveitis from AMD,” the investigators concluded. However, they added that their findings need confirmation from a “larger systematic study with greater power.”

The study report, “Age-related macular degeneration in patients with uveitis,” was published online in the British Journal of Ophthalmology.

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