Intermediate uveitis: long-term course and visual outcome

Aim: In this retrospective cohort study we investigated the long-term course and visual outcomes of intermediate uveitis (IU). Methods: We performed an institutional study of patients with IU with a follow-up of at least 10 years, followed at a tertiary referral centre. Results: We studied 29 patients with unilateral or bilateral IU. The average age at onset of IU was 31 (range 8-64) years. At onset, three patients (10%) had associated systemic disease (two with sarcoidosis and one with multiple sclerosis) and one patient had granuloma annulare. During the follow-up period, one additional patient was diagnosed with sarcoidosis and one with multiple sclerosis. The percentage of eyes with legal blindness and visual impairment gradually increased over time (from 9/53 (17%) at onset to 15/53 (28%) at 10-year follow-up), with macular oedema, cataract and vitreous opacities being the most common causes of vision loss. The presence of associated anterior uveitis was more frequently noted in patients younger than 20 years at onset. Remissions of intraocular inflammation of at least 1 year were noted in 10/29 (34%) of patients. The mean time-to-remission was 8.6 years; patients who had remissions were younger at the onset of IU than those with ongoing active IU (p = 0.036). Remissions of IU showed borderline association with the absence of systemic disease (p = 0.046). Conclusions: One-third of IU patients achieved a remission of their intraocular inflammation for longer than 1 year and had a mean time-to-remission of 8.6 years. Patients who were younger at onset of IU were more likely to achieve remission than those who were older at onset.