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First Author: F.Kretz GERMANY
Co Author(s): G. Auffarth M. Becker R. Max D. Plaza F. Mackensen
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Often single parameters as best corrected visual acuity (BCVA) or cell grades are used to judge treatment effect. This approach is handicapped by not accounting for many other activity parameters in the different uveitis subsets. Therefore we created and evaluated two non-parametric uveitis score-systems for uveitis activity.
Interdisciplinary Uveitis Center, Dept. of Opthalmology, University Hospital, Heidelberg
The score-systems consisted of BCVA, anterior chamber cell count, central retinal thickness-measurement, IOP, flare, vitreous haze, while SUSH III also contained the actual steroid dose and flaremeter measurements. 4 different patient selections were analyzed over a period of one year.
Over 1 year the TEAM group showed a significant reduction of 9.69 (p=0.000) for SUSH I and 11.6 (p=0.000) for SUSH III. The ADUR group showed a significant reduction of 13.47 (p=0.002) for SUSH I and of 17.42 (p=0.000) for SUSH III. In the Myfortic® group a statistic significant reduction was only found for SUSH III with 3.36 (p=0.037), while in the CellCept® group the reduction was only significant at the six month follow up visit with 3.42 (p=0.013) for SUSH III. Both research groups showed an increase in BCVA that stabilized from the 6 month visit on, while the other two groups had a stable BCVA during the whole follow up period. A negative correlation could be found between the BCVA and the SUSH score-systems.
Score-systems are a novelty in the activity grading of uveitis. They have the potential to improve evaluation of activity of uveitis and thus creating more uniformity in outcome measures. In study cohorts where the reduction of uveitis activity is the main goal, both score systems have a good predictability of uveitis activity and are superior to BCVA alone, while in groups formed by daily clinic patients with stable BCVA SUSH III gives a better predictability as the steroid dose is taken in account.