Evaluating the Impact of Uveitis on Visual Field Progression Using Large-Scale Real-World Data

Area of Science:

• Ophthalmology
• Glaucomatology
• Uveitis Research

Background:

• Uveitis is an inflammatory condition that can affect the eye.
• Glaucoma is a leading cause of irreversible blindness worldwide.
• Patients with uveitis are at increased risk of developing secondary glaucoma.

Purpose of the Study:

• To compare the rate of visual field (VF) loss in patients with uveitis and glaucoma versus those with primary open-angle glaucoma (POAG).
• To investigate the relationship between intraocular pressure (IOP) and the rate of VF loss in these groups.

Main Methods:

• Retrospective cohort study analyzing anonymized data from 5 English glaucoma clinics.
• Compared 205 eyes with uveitis and glaucoma to 4600 eyes with POAG.
• Utilized mixed-effects models and pointwise VF progression analysis to assess rates of VF loss (mean deviation loss ≥1.5 dB/year).

Main Results:

• Eyes with uveitis and glaucoma showed a significantly higher rate of VF progression (-0.49 dB/year) compared to POAG eyes (-0.37 dB/year).
• The relative risk of being a rapid progressor was 1.9 times higher in the uveitis-glaucoma group.
• Elevated IOP range and variability were observed in rapidly progressing uveitic eyes.

Conclusions:

• Visual field loss progresses more rapidly in glaucoma patients who also have uveitis.
• Glaucoma with uveitis nearly doubles the risk of rapid disease progression.
• Early identification of rapid progressors in this cohort is crucial for preserving visual function.