Original articleFactors Predicting Visual Acuity Outcome in Intermediate, Posterior, and Panuveitis: The Multicenter Uveitis Steroid Treatment (MUST) Trial
Section snippets
Methods
The MUST Trial—a comparative effectiveness trial comparing fluocinolone acetonide 0.59 mg implant therapy vs systemic therapy with corticosteroids supplemented in most cases with immunosuppression—randomized subjects having active or recently active (within 60 days) intermediate uveitis, posterior uveitis, or panuveitis to the alternative treatments. The MUST Trial (ClinicalTrials.gov Identifier: NCT00132691) was approved by governing institutional review boards at all participating clinical
Results
Among the 479 uveitic eyes of 255 patients enrolled in the MUST Trial, 475 eyes of 254 patients had complete visual acuity information at baseline and were assessed for the presenting visual acuity analyses. Characteristics of this population have been reported previously.7, 9 Four hundred twenty-nine eyes of 231 patients had complete visual acuity at the 2-year follow-up visit (excluding 2 eyes with no light perception at baseline, which could not have changed), and were used in the incidence
Discussion
Our results demonstrate in a detailed fashion that most uveitic eyes of participants in the MUST Trial had favorable visual outcomes, suggesting that severe cases of uveitis for which systemic corticosteroid therapy is indicated have a generally favorable prognosis under best practices systemic10 or implant11, 12 therapy in a subspecialty setting. Many more of the eyes initially 20/50 or worse improved than worsened, especially eyes with baseline BCVA of 20/200 or worse. The latter eyes often
Dr John H. Kempen is Professor of Ophthalmology and Epidemiology at the University of Pennsylvania Perelman School of Medicine. His research evaluates treatment for ocular inflammatory and infectious diseases. He is Chairman of the Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Cohort Study and Vice-Chairman of the Multicenter Uveitis Steroid Treatment (MUST) Trial Network. He is President and Co-Founder of the eyecare organization Sight for Souls, developing self-sustaining
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Cited by (0)
Dr John H. Kempen is Professor of Ophthalmology and Epidemiology at the University of Pennsylvania Perelman School of Medicine. His research evaluates treatment for ocular inflammatory and infectious diseases. He is Chairman of the Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Cohort Study and Vice-Chairman of the Multicenter Uveitis Steroid Treatment (MUST) Trial Network. He is President and Co-Founder of the eyecare organization Sight for Souls, developing self-sustaining comprehensive eye institutes in less-developed countries.
Mark L. Van Natta is an associate scientist in the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health. He received a Masters of Health Science in Biostatistics from the School in 1987. He has worked at the Johns Hopkins Center for Clinical Trials since 1985 and was the director of the Coordinating Center for the National Eye Institute-sponsored Studies of Ocular Complications of AIDS from 2013–2015.
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