Clinical characteristics of inflammatory ocular disease in anti-neutrophil cytoplasmic antibody associated vasculitis

a retrospective cohort study

Patompong Ungprasert, Cynthia Crowson, Rodrigo Cartin-Ceba, James A. Garrity, Wendy M. Smith, Ulrich Specks, Eric Lawrence Matteson, Ashima Makol

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: To characterize the clinical correlates and outcome of inflammatory ocular disease (IOD) among patients with ANCA-associated vasculitides (AAV).

Methods: Medical records of potential cases of AAV seen at Mayo Clinic from 2003 to 2013, inclusive, were reviewed to identify confirmed cases meeting the diagnosis of AAV using the Chapel Hill Consensus Conference 2012 descriptors. Records of confirmed cases of AAV were then further reviewed for IOD, and clinical characteristics, treatment and outcomes abstracted.

Results: A total of 1171 confirmed cases of AAV were identified of which 183 patients (mean age 49.0 years; 51% female; 95% Caucasian) had IOD. The most common manifestation of IOD was injection of the eye (57%) followed by eye pain (46%) and visual acuity loss (18%). Scleritis was the most common type of IOD (22%) followed by episcleritis (21%), orbital inflammation (18%), lacrimal duct stenosis (10%) and uveitis (9%). Oral glucocorticoids were used to treat IOD in the majority of patients (96%). CYC and rituximab were the most frequently used immunosuppressive agents (54 and 36%, respectively). Of those with orbital inflammation, 52% underwent therapeutic surgical intervention. Clinical remission of IOD was achieved in 91% of patients but relapses were seen in 23%. Significant visual acuity loss was observed in only six patients.

Conclusion: IOD is a common manifestation of AAV and seen in about 16% of patients with AAV. Scleritis, episcleritis and orbital inflammation are the most common subtypes. Most patients respond well to glucocorticoids and immunosuppression, but relapse of IOD is common.

Original languageEnglish (US)
Pages (from-to)1763-1770
Number of pages8
JournalRheumatology (Oxford, England)
Volume56
Issue number10
DOIs
StatePublished - Oct 1 2017

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Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Eye Diseases
Cohort Studies
Retrospective Studies
Scleritis
Inflammation
Glucocorticoids
Visual Acuity
Eye Pain
Recurrence
Lacrimal Apparatus
Uveitis
Immunosuppressive Agents
Immunosuppression
Medical Records
Consensus
Pathologic Constriction

Keywords

  • ANCA associated vasculitis
  • cohort study
  • inflammatory eye disease
  • orbital inflammation

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

Cite this

Clinical characteristics of inflammatory ocular disease in anti-neutrophil cytoplasmic antibody associated vasculitis : a retrospective cohort study. / Ungprasert, Patompong; Crowson, Cynthia; Cartin-Ceba, Rodrigo; Garrity, James A.; Smith, Wendy M.; Specks, Ulrich; Matteson, Eric Lawrence; Makol, Ashima.

In: Rheumatology (Oxford, England), Vol. 56, No. 10, 01.10.2017, p. 1763-1770.

Research output: Contribution to journalArticle

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title = "Clinical characteristics of inflammatory ocular disease in anti-neutrophil cytoplasmic antibody associated vasculitis: a retrospective cohort study",
abstract = "Objective: To characterize the clinical correlates and outcome of inflammatory ocular disease (IOD) among patients with ANCA-associated vasculitides (AAV).Methods: Medical records of potential cases of AAV seen at Mayo Clinic from 2003 to 2013, inclusive, were reviewed to identify confirmed cases meeting the diagnosis of AAV using the Chapel Hill Consensus Conference 2012 descriptors. Records of confirmed cases of AAV were then further reviewed for IOD, and clinical characteristics, treatment and outcomes abstracted.Results: A total of 1171 confirmed cases of AAV were identified of which 183 patients (mean age 49.0 years; 51{\%} female; 95{\%} Caucasian) had IOD. The most common manifestation of IOD was injection of the eye (57{\%}) followed by eye pain (46{\%}) and visual acuity loss (18{\%}). Scleritis was the most common type of IOD (22{\%}) followed by episcleritis (21{\%}), orbital inflammation (18{\%}), lacrimal duct stenosis (10{\%}) and uveitis (9{\%}). Oral glucocorticoids were used to treat IOD in the majority of patients (96{\%}). CYC and rituximab were the most frequently used immunosuppressive agents (54 and 36{\%}, respectively). Of those with orbital inflammation, 52{\%} underwent therapeutic surgical intervention. Clinical remission of IOD was achieved in 91{\%} of patients but relapses were seen in 23{\%}. Significant visual acuity loss was observed in only six patients.Conclusion: IOD is a common manifestation of AAV and seen in about 16{\%} of patients with AAV. Scleritis, episcleritis and orbital inflammation are the most common subtypes. Most patients respond well to glucocorticoids and immunosuppression, but relapse of IOD is common.",
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author = "Patompong Ungprasert and Cynthia Crowson and Rodrigo Cartin-Ceba and Garrity, {James A.} and Smith, {Wendy M.} and Ulrich Specks and Matteson, {Eric Lawrence} and Ashima Makol",
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T1 - Clinical characteristics of inflammatory ocular disease in anti-neutrophil cytoplasmic antibody associated vasculitis

T2 - a retrospective cohort study

AU - Ungprasert, Patompong

AU - Crowson, Cynthia

AU - Cartin-Ceba, Rodrigo

AU - Garrity, James A.

AU - Smith, Wendy M.

AU - Specks, Ulrich

AU - Matteson, Eric Lawrence

AU - Makol, Ashima

PY - 2017/10/1

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N2 - Objective: To characterize the clinical correlates and outcome of inflammatory ocular disease (IOD) among patients with ANCA-associated vasculitides (AAV).Methods: Medical records of potential cases of AAV seen at Mayo Clinic from 2003 to 2013, inclusive, were reviewed to identify confirmed cases meeting the diagnosis of AAV using the Chapel Hill Consensus Conference 2012 descriptors. Records of confirmed cases of AAV were then further reviewed for IOD, and clinical characteristics, treatment and outcomes abstracted.Results: A total of 1171 confirmed cases of AAV were identified of which 183 patients (mean age 49.0 years; 51% female; 95% Caucasian) had IOD. The most common manifestation of IOD was injection of the eye (57%) followed by eye pain (46%) and visual acuity loss (18%). Scleritis was the most common type of IOD (22%) followed by episcleritis (21%), orbital inflammation (18%), lacrimal duct stenosis (10%) and uveitis (9%). Oral glucocorticoids were used to treat IOD in the majority of patients (96%). CYC and rituximab were the most frequently used immunosuppressive agents (54 and 36%, respectively). Of those with orbital inflammation, 52% underwent therapeutic surgical intervention. Clinical remission of IOD was achieved in 91% of patients but relapses were seen in 23%. Significant visual acuity loss was observed in only six patients.Conclusion: IOD is a common manifestation of AAV and seen in about 16% of patients with AAV. Scleritis, episcleritis and orbital inflammation are the most common subtypes. Most patients respond well to glucocorticoids and immunosuppression, but relapse of IOD is common.

AB - Objective: To characterize the clinical correlates and outcome of inflammatory ocular disease (IOD) among patients with ANCA-associated vasculitides (AAV).Methods: Medical records of potential cases of AAV seen at Mayo Clinic from 2003 to 2013, inclusive, were reviewed to identify confirmed cases meeting the diagnosis of AAV using the Chapel Hill Consensus Conference 2012 descriptors. Records of confirmed cases of AAV were then further reviewed for IOD, and clinical characteristics, treatment and outcomes abstracted.Results: A total of 1171 confirmed cases of AAV were identified of which 183 patients (mean age 49.0 years; 51% female; 95% Caucasian) had IOD. The most common manifestation of IOD was injection of the eye (57%) followed by eye pain (46%) and visual acuity loss (18%). Scleritis was the most common type of IOD (22%) followed by episcleritis (21%), orbital inflammation (18%), lacrimal duct stenosis (10%) and uveitis (9%). Oral glucocorticoids were used to treat IOD in the majority of patients (96%). CYC and rituximab were the most frequently used immunosuppressive agents (54 and 36%, respectively). Of those with orbital inflammation, 52% underwent therapeutic surgical intervention. Clinical remission of IOD was achieved in 91% of patients but relapses were seen in 23%. Significant visual acuity loss was observed in only six patients.Conclusion: IOD is a common manifestation of AAV and seen in about 16% of patients with AAV. Scleritis, episcleritis and orbital inflammation are the most common subtypes. Most patients respond well to glucocorticoids and immunosuppression, but relapse of IOD is common.

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KW - cohort study

KW - inflammatory eye disease

KW - orbital inflammation

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DO - 10.1093/rheumatology/kex261

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JO - Rheumatology (United Kingdom)

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