Clinical and demographic factors impact visual acuity in retinal vasculitis

By Sarah Guy, medwireNews Reporter

Just over one-third of individuals with retinal vasculitis will experience vision loss despite undergoing therapy for the condition, while approximately the same proportion will experience some improvement, show study results.

Visual acuity improvement was more likely in patients of races other than non-Hispanic White, and those with poor visual acuity at baseline, before treatment, the researchers say.

Furthermore, patients with retinal vasculitis secondary to ocular infection were significantly more likely to have improved visual acuity compared with those without an infection. However, the research team cautions that definitive conclusions cannot be drawn since an inadequate number of participants were infected with any single infection.

"Identifying subsets of retinal vasculitis and the prognosis of each subset will add a wealth of information about this disease and will help find optimal treatment options," say Jennifer Ku, from Oregon Health & Science University in Portland, USA and colleagues in the Archives of Ophthalmology.

They reviewed the ophthalmologic records of 207 patients with retinal vasculitis, identified by features including active inflammation in the anterior chamber of the eye and/or the vitreous humor. The most common symptoms in retinal vasculitis patients are blurred or decreased vision, floaters, and scotomata, although the disease may also be asymptomatic, explain Ku et al.

After a median 4-month follow up, the overall mean annual change in visual acuity among the 203 eyes that had at least two follow ups was 0.01 logMAR units per year, corresponding to a 0.1-line decrease on the Snellen chart, report the researchers.

Multivariate analysis showed that compared with non-Hispanic Whites, individuals of other races were a significant 3.54 times more likely to experience improvement in visual acuity measured on the Snellen and logMAR acuity charts. Visual acuity in the non-Hispanic White group decreased by 0.02 logMAR units per year while those of other races improved by an average 0.04 units.

Those with a greater logMAR value at their initial consultation (eg, 20/200 rather than 20/20) - indicating worse visual acuity - were also a significant 6.68 times per 1 logMAR unit more likely to show improvement during the study.

That 39.4% of participants experienced loss of vision despite therapy, while 37.4% experienced improvement are novel findings, write the researchers.

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