Table 3.
Factors associated with favorable outcomes following periocular corticosteroid injection*
| Outcome* | Resolution of Inflammation | Improvement in VA (20/40 or better) | Improvement in ME affecting VA | ||||
|---|---|---|---|---|---|---|---|
| Covariate | Description | Adjusted HR (95% CI) | p | Adjusted HR (95% CI) | p | Adjusted HR (95% CI) | p |
| Site of uveitis | Anterior | 1.0 | - | 1.0 | - | 1.0 | |
| Intermediate | 0.44 (0.35-0.55) | <.0001 | 0.74 (0.53-1.04) | 0.08 | 0.70 (0.40-1.24) | 0.23 | |
| Posterior or panuveitis | 0.44 (0.35-0.54) | <.0001 | 0.60 (0.44-0.81) | 0.001 | 0.57 (0.30-1.08) | 0.08 | |
| Race | White | 1.0 | - | 1.0 | - | 1.0 | - |
| African-American | 1.07 (0.85-1.34) | 0.58 | 0.77 (0.54-1.09) | 0.14 | 0.98 (0.54-1.80) | 0.96 | |
| Hispanic/Native American | 1.01 (0.58-1.76) | 0.97 | 0.52 (0.28-0.98) | 0.04 | 1.32 (0.68-2.58) | 0.41 | |
| Other | 0.69 (0.44-1.07) | 0.10 | 0.60 (0.33-1.09) | 0.10 | 1.88 (1.10-3.20) | 0.02 | |
| Unknown | 0.70 (0.37-1.30) | 0.26 | 0.14 (0.03-0.70) | 0.02 | 0.53 (0.20-1.41) | 0.20 | |
| Sex | Male | 1.0 | - | 1.0 | - | 1.0 | - |
| Female | 0.94 (0.77-1.14) | 0.51 | 0.80 (0.61-1.05) | 0.11 | 0.75 (0.45-1.24) | 0.26 | |
| Age, years | <20 | 1.0 | - | 1.0 | - | 1.0 | - |
| 20 - <50 | 0.96 (0.76-1.21) | 0.73 | 0.86 (0.61-1.21) | 0.39 | 0.95 (0.48-1.90) | 0.88 | |
| 50+ | 0.94 (0.71-1.25) | 0.67 | 0.50 (0.32-0.78) | 0.002 | 1.09 (0.46-2.57) | 0.85 | |
| Uveitis duration** | Per year | 0.97 (0.95-0.99) | 0.005 | 0.95 (0.92-0.98) | 0.0005 | 0.98 (0.94-1.02) | 0.39 |
| Systemic therapy*** | Neither | 1.0 | - | 1.0 | - | 1.0 | - |
| Systemic corticosteroids only | 0.90 (0.65-1.24) | 0.50 | 0.77 (0.41-1.44) | 0.41 | 0.82 (0.37-1.83) | 0.64 | |
| Immunosuppressives +/− systemic corticosteroids | 0.72 (0.43-1.21) | 0.21 | 0.35 (0.14-0.84) | 0.02 | 0.63 (0.20-1.97) | 0.43 | |
| Number of injections | 1 | 1.0 | - | 1.0 | - | 1.0 | - |
| 2 or 3 | 0.91 (0.76-1.10) | 0.33 | 0.91(0.69-1.20) | 0.52 | 1.33 (0.76-2.32) | 0.32 | |
| 4 or more | 0.94 (0.74-1.18) | 0.59 | 0.89 (0.64-1.24) | 0.50 | 1.60 (0.84-3.07) | 0.16 | |
Multivariable survival analyses (Cox proportional hazards model) for favorable outcomes. For all categorical variables, the first row represents the reference category.
Outcome definitions: Resolution of inflammation= improvement from “active” or “slightly active” inflammation to “no activity.” Improvement in visual acuity (VA)= Eyes that showed improvement from worse than 20/40 VA to 20/40 or better VA. Improvement of macular edema (ME) affecting VA= ME affecting VA was defined as eyes with VA worse than 20/40 where ME was recorded as the primary cause of vision loss at the time of first periocular corticosteroid injection. Improvement in ME in these cases was defined as at least 0.2 logMAR of improvement in VA following periocular corticosteroid injection.
Uveitis Duration of uveitis reflects duration at the time of first periocular injection.
Systemic Therapy: Systemic therapy reflects the use of systemic corticosteroids or immunosuppressive drugs at the time of or prior to the first injection.
Systemic corticosteroids includes any systemic corticosteroid use with no concomitant immunosuppressive therapy use (n=215); immunosuppressive drugs include all immunosuppressive drugs listed in table 1 as well as cases where immunosuppressives were used in combination with oral corticosteroids (n=263).
HR=hazard ratio; CI=confidence interval.