PURPOSE To estimate the incidence of medication-free remission of chronic anterior uveitis and identify predictors thereof. DESIGN Retrospective cohort study. PARTICIPANTS Patients diagnosed with anterior uveitis of longer than 3 months' duration followed up at United States tertiary uveitis care facilities. METHODS Estimation of remission incidence and identification of associated predictors used survival analysis. MAIN OUTCOME MEASURES Incidence of medication-free remission. For the primary analysis, remission was defined as inactive uveitis while off treatment at all visits spanning an interval of at least 90 days or-for patients who did not return for follow-up after 90 days-remaining inactive without receiving suppressive medications at all of the last visits. Association of factors potentially predictive of medication-free remission was also studied. RESULTS Two thousand seven hundred ninety-five eyes of 1634 patients with chronic anterior uveitis were followed up over 7936 eye-years (4676 person-years). The cumulative medication-free, person-year remission incidence within 5 years was 32.7% (95% confidence interval [CI], 30.4%-35.2%). Baseline clinical factors predictive of reduced remission incidence included longer duration of uveitis at presentation (for 2 to 5 years vs. less than 6 months: adjusted hazard ratio [aHR], 0.61; 95% CI, 0.44-0.83), bilateral uveitis (aHR, 0.75; 95% CI, 0.59-0.96), prior cataract surgery (aHR, 0.70; 95% CI 0.56-0.88), and glaucoma surgery (aHR, 0.63; 95% CI, 0.45-0.90). Two time-updated characteristics were also predictive of reduced remission incidence: keratic precipitates (aHR, 0.36; 95% CI, 0.21-0.60) and synechiae (aHR, 0.62; 95% CI, 0.41-0.93). Systemic diagnosis with juvenile idiopathic arthritis and spondyloarthropathy were also associated with reduced remission incidence. Older age at presentation was associated with higher incidence of remission (for age ≥40 years vs. <40 years: aHR, 1.29; 95% CI, 1.02-1.63). CONCLUSIONS Approximately one third of patients with chronic anterior uveitis remit within 5 years. Longer duration of uveitis, younger age, bilateral uveitis, prior cataract surgery, glaucoma surgery, presence of keratic precipitates and synechiae, and systemic diagnoses of juvenile idiopathic arthritis and spondyloarthropathy predict reduced remission incidence; patients with these factors should be managed taking into account the higher probability of a longer disease course.

中文翻译：

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预测慢性前葡萄膜炎缓解的因素。

目的评估慢性前葡萄膜炎无药物缓解的发生率并确定其预测因素。设计回顾性队列研究。参加者在美国三级葡萄膜炎护理机构对被诊断患有前葡萄膜炎病程超过3个月的患者进行了随访。方法采用生存分析方法评估缓解率并确定相关的预测指标。主要观察指标无药物缓解的发生率。对于主要分析，缓解定义为在至少90天的间隔内所有就诊时停用治疗性葡萄膜炎，或者-对于90天后仍未随访的患者，在所有治疗期间均未治疗但仍未治疗的情况最后一次访问。还研究了可能预测无药物缓解的因素的关联。结果对1634例慢性前葡萄膜炎患者的279眼进行了随访，随访时间超过7936眼年（4676人年）。5年内累积的无药物治疗，人年缓解率是32.7％（95％置信区间[CI]，30.4％-35.2％）。预测缓解率降低的基线临床因素包括出现葡萄膜炎的持续时间更长（持续2至5年vs.少于6个月：调整后的危险比[aHR]为0.61； 95％CI为0.44-0.83），双侧葡萄膜炎（aHR ，0.75； 95％CI，0.59-0.96），先前的白内障手术（aHR，0.70； 95％CI 0.56-0.88）和青光眼手术（aHR，0.63； 95％CI，0.45-0.90）。两个时间更新的特征还可以预测缓解率的降低：角质沉淀（aHR，0.36; 95％CI，0.21-0.60）和粘连（aHR，0.62; 95％CI，0.41-0.93）。少年特发性关节炎和脊椎关节炎的系统性诊断也与缓解率降低相关。就诊时年龄较大与缓解率较高相关（年龄≥40岁vs. <40岁：aHR，1.29； 95％CI，1.02-1.63）。结论约有三分之一的慢性前葡萄膜炎患者在5年内缓解。葡萄膜炎病程更长，年龄更小，双侧葡萄膜炎，先前的白内障手术，青光眼手术，存在角膜沉淀和粘连以及系统性诊断为幼年特发性关节炎和脊椎病可预示缓解率降低；具有这些因素的患者应考虑更长的病程可能性进行管理。