Although vision loss is a rare complication, anterior uveitis is a potentially sight-threatening condition for the working population and has significant implications on the individual and their ability to function independently. To highlight the risk factors and complications contributing to visual deterioration, a recent study identified the most significant complications leading to moderate and severe vision loss: uveitic glaucoma, cystoid macular edema and corneal scar. It also noted older age, chronic anterior uveitis, infectious etiologies and poor presenting best-corrected visual acuity as multivariate significant risk factors for developing these complications and permanent loss of vision.

The researchers observed 2,526 eyes of 1,814 anterior uveitis patients with a mean follow-up of 6.8 years. Moderate vision loss occurred in 9.5% of eyes during the follow-up period, of which 3.8% could be attributed to uveitis. Severe vision loss occurred in 3.2%, of which 1.5% were due to uveitis.

Chronic anterior uveitis was significantly associated with development of cystoid macular edema, the second most common ocular complication, and accounted for approximately one-quarter of eyes with permanent vision loss due to anterior uveitis. If repeated evidence also recognizes chronic anterior uveitis as a detrimental risk factor for visual outcomes, the researchers find it reasonable to emphasize early initiation of treatment, aggressive therapy and regular follow-up as fundamental to uveitis management to minimize complications.

“A focus on reducing duration of intraocular inflammation as well as early diagnosis and aggressive management of ocular complications secondary to anterior uveitis, particularly glaucoma, will be essential for minimizing vision loss in this vulnerable population,” they conclude in their paper on the study.

Al-Ani HH, Sims J, Tomkins-Netzer O, et al. Vision loss in anterior uveitis. Br J Ophthlamol. April 3, 2020. [Epub ahead of print].