Background/Purpose: Uveitis is a significant cause of visual impairment in the U.S., with a prevalence of 438 per 100,000 persons [1]. It is anatomically classified into anterior, intermediate, posterior, and panuveitis, and is frequently associated with systemic autoimmune conditions. Management strategies include corticosteroids, immunomodulatory agents, and biologics, tailored to disease severity and underlying etiology [2].

Methods: This retrospective cohort study includes patients ≥18 years diagnosed with uveitis seen at Mayo Clinic Florida Rheumatology Clinic between 10/12/2021 and 10/12/2023. Patients were identified using ICD-10 and location codes. Data include demographics, diagnostic testing, ocular features, serologies, imaging, comorbidities, treatments, morbidity, and mortality. Categorical and continuous variables are analyzed using Fisher’s exact and Kruskal-Wallis tests, respectively. Time to remission was assessed using Kaplan-Meier analysis. The primary objective was to investigate the epidemiology, clinical associations, and outcomes of uveitis. Secondary objectives included identifying risk factors, evaluating diagnostic strategies, and determining the most effective treatment regimens. A p-value < 0.05 was considered significant.

Results: A total of 148 adult patients with uveitis were analyzed: anterior (n=125), intermediate (n=6), posterior (n=8), and panuveitis (n=9). The mean age was 51.7 years, and 114 (77%) were female. Most patients were White (76.4%) and non-Hispanic (88.5%). Bilateral involvement was observed in 75.5% of cases (Table 1). Anterior uveitis was most prevalent (84.5%), with iritis being the most common subtype (65.5%). Sarcoidosis was significantly associated with intermediate/posterior uveitis (p=0.029). Visual acuity was preserved in most patients, but those with panuveitis had higher rates of visual impairment. Glaucoma (21.6%) and cataract (41.9%) were notable complications, especially in posterior and panuveitis (p=0.035). Corticosteroids were administered in 98% of cases; topical use predominated, though intraocular delivery was more frequent in posterior/panuveitis (p=0.006). Methotrexate (35.1%) and adalimumab (45.9%) were the most used immunosuppressants. Mycophenolate use varied significantly across types (p< 0.001). Remission was achieved in 92.6% of patients (Figure 1). Adalimumab was associated with higher remission in posterior/panuveitis (p=0.037), and mycophenolate and methotrexate were also linked to remission (Table 2).

Conclusion: This retrospective study demonstrates high remission rates in adult uveitis patients, with 137 (92.6%) achieving remission. Anterior uveitis was the most common subtype, accounting for 115 cases (92.0%). Corticosteroids were widely used, but adalimumab and mycophenolate were significantly effective in posterior/panuveitis. Early diagnosis and targeted therapy are key to improving uveitis outcomes.References: [1] Thorne JE, Skup M, Tundia N, et al. JAMA Ophthalmol. 2016;134(11):1237–1245.[2] Nguyen QD, Merrill PT, Jaffe GJ, et al. Lancet. 2016;388(10050):1183–1192.

Table 1. Combined baseline characteristics, laboratory findings, autoantibody profiles, and HLA typing across uveitis subtypes. Anterior uveitis was the most prevalent (84.5%). Significant differences were observed in age distribution and HLA-B27 positivity (p=0.062, 0.349 respectively). Autoantibodies such as ANA (36.2%) and HLA-B27 (35.0%) were commonly present. Bilateral eye involvement was dominant across all subtypes (75.5%). These findings highlight the clinical heterogeneity and immunological associations in non-infectious uveitis.

Table 2. Diagnosis, treatment, complications, and outcomes of uveitis by anatomical subtype. Anterior uveitis was the most common (84.5%), with iritis and iridocyclitis predominating. Cataract and glaucoma were the most frequent complications. Corticosteroids were widely used, but mycophenolate, adalimumab, and methotrexate showed greater association with remission in posterior and panuveitis. Overall remission was achieved in 92.6% of patients, with relapse rates highest in intermediate and panuveitis.

Figure 1: Kaplan-Meier survival analysis showing time to remission among patients with anterior, intermediate, posterior, and panuveitis over a 48-month period. Most patients with anterior uveitis achieved early remission, while posterior and panuveitis cases showed slower remission trends. Shaded areas represent 95% confidence intervals. No statistically significant difference in time to remission was observed between uveitis types (Log-rank test, p = 0.414).

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/investigating-epidemiology-clinical-associations-and-outcomes-of-uveitis-a-retrospective-cohort-study/