Effect of Vitreomacular Adhesion on the Treatment Outcomes in the STOP-Uveitis Clinical Trial for Non-infectious Uveitis

Overview

Journal J Ophthalmic Inflamm Infect

Publisher Springer

Specialty Ophthalmology

Date 2019 Jul 21

PMID 31325001

Citations 4

Authors

Muhammad Hassan

Nam V Nguyen

Muhammad Sohail Halim

Rubbia Afridi

Mohammad Ali Sadiq

Samendra Karkhur

Erin Vigil

Selen Karabekirogullari

Quan Dong Nguyen

Diana V Do

Yasir J Sepah

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the role of vitreomacular adhesion (VMA) in visual and anatomic outcomes in patients with non-infectious uveitis.

Design: Phase 2 clinical trial PARTICIPANTS: Data from the Safety, Tolerability, and Efficacy of Tocilizumab in Patients with Non-infectious Uveitis (STOP-Uveitis) study was analyzed.

Methods: In the STOP-Uveitis study, patients with non-infectious uveitis (NIU) received monthly intravenous infusions of either 4 or 8 mg/kg tocilizumab until month 6 (M6). Spectral domain optical coherence tomography (SD-OCT) images of patients that completed M6 of the study were analyzed at baseline to stratify the patients by the presence (VMA+) or absence (VMA-) of VMA. Patients with vitreomacular traction (VMT) or epiretinal membrane causing structural abnormalities within center 1 mm were excluded. All images were graded by two independent graders.

Main Outcome Measures: Mean change in best-corrected visual acuity (BCVA), central retinal thickness (CRT), and vitreous haze (VH) at M6.

Results: Out of 37 patients randomized in the STOP-Uveitis study, 48 eyes (27 patients) were eligible based on the study criteria. At baseline, 19 eyes were classified as VMA+, and 32 eyes were classified as VMA-. The distribution of two doses of TCZ (4 mg/kg and 8 mg/kg) were similar between the two groups. At M6, the mean improvement in BCVA was 2.00 ± 5.3 and 6.50 ± 7.98 letters in the VMA+ and VMA- groups, respectively (p = 0.02). The mean improvement in CRT was 34.85 ± 72.36 and 80.37 ± 157.21 μm in the VMA+ and VMA- groups, respectively (p = 0.18). Similarly, the mean change in VH was - 0.65 ± 0.47 and - 0.76 ± 0.71 in the VMA+ and VMA- groups, respectively (p = 0.32). Out of 16 eyes with VMA at baseline, 3 eyes developed posterior vitreous detachment (PVD) at M6. The mean change in BCVA was significantly higher (p = 0.02), while CRT and VH score were similar (p > 0.05) in eyes with PVD compared to eyes with persistent VMA.

Conclusions: The absence of VMA or development of PVD in eyes with VMA seems to have a beneficial effect on the vision of subjects receiving treatment for uveitis. Therefore, patients with uveitis should be assessed using SD-OCT for the presence of vitreomacular interface abnormalities.

Citing Articles

Association of OCT biomarkers and visual impairment in patients with diabetic macular oedema with vitreomacular adhesion.

Subramanian B, Devishamani C, Raman R, Ratra D PLoS One. 2023; 18(7):e0288879.

PMID: 37463157 PMC: 10353796. DOI: 10.1371/journal.pone.0288879.

Annexin A1 Mimetic Peptide and Piperlongumine: Anti-Inflammatory Profiles in Endotoxin-Induced Uveitis.

Girol A, de Freitas Zanon C, Caruso I, de Souza Costa S, Ribeiro Souza H, Cornelio M Cells. 2021; 10(11).

PMID: 34831393 PMC: 8625584. DOI: 10.3390/cells10113170.

Continued smoking and posterior vitreous adhesion in the elderly evaluated on swept-source optical coherence tomography.

Toyama T, Hashimoto Y, Kawai H, Azuma K, Shiraya T, Araki F Sci Rep. 2020; 10(1):18460.

PMID: 33116238 PMC: 7595182. DOI: 10.1038/s41598-020-75590-9.

Posterior segment inflammatory outcomes assessed using fluorescein angiography in the STOP-UVEITIS study.

Sadiq M, Hassan M, Afridi R, Halim M, Do D, Sepah Y Int J Retina Vitreous. 2020; 6:47.

PMID: 33042579 PMC: 7539516. DOI: 10.1186/s40942-020-00245-w.

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