Clinical characteristics of non-infectious uveitis treated with and without systemic immunomodulatory therapy.

OBJECTIVE: To compare the patient characteristics and long-term outcomes for those treated with and without systemic immunomodulatory therapy (IMT) for non-infectious uveitis (NIU). DESIGN: Retrospective cohort study. PARTICIPANTS: All consecutive adults with NIU receiving care at 5 uveitis subspecialty tertiary care clinics between 2010 and 2021. METHODS: Clinical outcomes were evaluated on initial presentation and at the last available follow-up. The main outcome measures were baseline characteristics and final visual acuity. RESULTS: A total of 914 NIU patients (418 IMT, 496 non-IMT) with a median age of 51.0 years and 57.4% female were identified. Over half the patients had bilateral disease, with a significantly higher proportion of bilateral cases in the IMT group compared with the non-IMT group (p < 0.001). The IMT group was more likely to have chronic uveitis (p < 0.001), with a higher proportion of patients experiencing cataracts and cystoid macular edema (p < 0.001 for both). A significantly higher proportion of non-IMT patients had anterior uveitis and an idiopathic etiology (p < 0.001). Overall, visual acuity improved significantly from baseline to last follow-up in the entire cohort (p < 0.001), with a slightly better improvement in the IMT group. Multivariable linear regression analysis suggested that baseline visual acuity and panuveitis were significant predictors of final visual acuity (p < 0.001 for both). CONCLUSIONS: NIU patients on IMT are often younger, suffer from bilateral and chronic uveitis, and are more likely to have ocular complications. Those in the non-IMT group are more likely to have anterior idiopathic NIU. Baseline visual acuity and panuveitis are the main predictors of final vision outcomes among patients with NIU.

Research productivity of ophthalmology residents and its relationship to academic career outcomes.

OBJECTIVE: To assess the impact of ophthalmology resident research and its relationship to subsequent practice. DESIGN: Cross-sectional study. PARTICIPANTS: Three hundred and twenty residents of Canadian ophthalmology programs graduating between 2009 and 2020. METHODS: Bibliometric data were obtained for each resident from Scopus. Indices of scholarly productivity included number of publications, h-index, m-quotient, and total citations. Demographic and career data were obtained from faculty listings and professional and regulatory web sites. Career outcomes included location and subspecialty of fellowship training and type of ultimate practice (academic vs community). RESULTS: In total, 208 of 320 graduates (65%) published at least 1 peer-reviewed article during residency. Bibliometric indices, including numbers of papers, h-index, and total citations, were significantly higher for male residents and residents who pursued academic and subspecialized practices. No significant trends were seen regarding scholarly productivity and fellowship match outcomes (e.g., location and subspecialty of fellowship). The bulk of resident research projects was of lower tiers of evidence, including retrospective studies (n = 111) and case reports (n = 108). Five-year scholarly impact of resident research decreased over time (h-index, m = -0.14; p < 0.01) despite stable publication volumes. CONCLUSIONS: Greater scholarly activity in residency corresponds to more academic and subspecialized practices but is not associated with type of fellowship. The impact of resident research declined between 2009 and 2020. Sex-based disparities exist.

OPTICAL COHERENCE TOMOGRAPHY FEATURES IN IDIOPATHIC NONINFECTIOUS INTERMEDIATE, POSTERIOR, OR PANUVEITIS.

PURPOSE: To characterize optical coherence tomography features in patients with idiopathic intermediate, posterior, or panuveitis. METHODS: This is a retrospective case series of all consecutive cases of idiopathic intermediate, posterior, or panuveitis at four tertiary care centres between 2010 and 2021. RESULTS: A total of 94 eyes (55 patients) were followed for an average duration of 29.8 (SD 21) months. The median central macular thickness was 284 µ m at baseline and 267 µ m at last follow-up. At baseline and last follow-up, respectively, 24% and 20% of uveitic eyes had intraretinal fluid, 12% and 1% subretinal fluid, and 43% and 54% epiretinal membrane. In addition, ellipsoid zone abnormalities on en-face were noted in 34% and 19% of cases at baseline and last follow-up, respectively. The baseline median visual acuity was significantly lower among cases with ellipsoid zone en-face slab abnormalities compared with those without (0.2 logarithm of minimum angle of resolution [interquartile range: 0-0.6] vs. 0.1 logarithm of minimum angle of resolution [interquartile range: 0-0.3], P = 0.0051). CONCLUSION: With initiation of treatment, the central macular thickness, intraretinal fluid, subretinal fluid, and ellipsoid zone en-face abnormalities improved over time, whereas the number of cases with epiretinal membrane increased among eyes with idiopathic intermediate, posterior, and panuveitis. Presence of ellipsoid zone en-face abnormalities at presentation may be associated with worse visual acuity.