Author Block: Saanwalshah S. Saincher, Chloe Gottlieb
Author Disclosure Block: S.S. Saincher: Any direct financial payments including receipt of honoraria; Name of for-profit or not-for-profit organization(s); The Ottawa Hospital Research Institute. Description of relationship(s); Summer Student. C. Gottlieb: None.

Abstract Body:

Purpose: The relationship between different immunosuppressive treatments and etiologies of ocular inflammation with inflammation relapse is not well understood. To address this, this study investigates the prevalence of relapse and the association between different immunosuppressive treatments and etiology of ocular inflammation for non-infectious ocular inflammatory disease with the duration of quiescence following treatment discontinuation.
Study Design: Retrospective chart review from The University of Ottawa Eye Institute, Ottawa, Ontario, Canada.
Methods: Inclusion criteria were: patients with non-infectious ocular inflammatory disease (uveitis, scleritis, and episcleritis) and patients with ≥2 visits spanning ≥90 days and follow-up within 12 months. Patient demographic information, age, and data from patient visits were collected at defined time points. For patients that had achieved complete remission, the time before treatment discontinuation and the duration of quiescence (after treatment discontinuation) was calculated. For those patients with a relapse in ocular inflammation, the time to treatment discontinuation and the duration of quiescence until treatment re-initiation was calculated.
Results: 145 patients (29.29%) were weaned off treatment while the other 350 patients (70.7%) continued treatment. 125 patients (25.25%) achieved complete remission while 20 patients (4.04%) had a relapse in inflammation after treatment discontinuation. Mycophenolate mofetil had the longest period of remission (68 months) among patients with ocular inflammation with no systemic disease. Methotrexate and corticosteroids had the longest period of quiescence for ocular inflammation with systemic disease (51 months and 50.1 months respectively). 88.88% of patients with panuveitis treated with corticosteroids achieved complete resolution. Patients with birdshot chorioretinopathy discontinued treatment after 64 months and had a relapse in inflammation after 15 months. 40% of patients with scleritis/episcleritis (the highest) achieved complete remission while 1 patient (2.22%) had a relapse in inflammation following treatment discontinuation. 50% of these patients were treated with corticosteroids and another 33.33% were treated with methotrexate.
Conclusions: In this study period, most patients required long term therapy. Among those that discontinued treatment, it was more common to achieve complete remission rather than have a relapse in inflammation. Mycophenolate mofetil was the best treatment for ocular inflammation with no systemic disease while methotrexate and corticosteroids were best for ocular inflammation with systemic disease. Corticosteroids were also effective treatments for panuveitis. Patients with scleritis/episcleritis treated with corticosteroids or methotrexate had the best outcomes, while patients with birdshot chorioretinopathy had the poorest outcomes.