Clinical characteristics of inflammatory ocular disease in anti-neutrophil cytoplasmic antibody associated vasculitis: A retrospective cohort study

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

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

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 (United Kingdom)
Volume56
Issue number10
DOIs
StatePublished - Oct 1 2017

Keywords

  • ANCA associated vasculitis
  • Cohort study
  • Inflammatory eye disease
  • Orbital inflammation

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

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