Evidence map›Paper›PMID 32628922›Full record

Trial reportAmerican journal of ophthalmology2020

Incidence and Outcome of Uveitic Glaucoma in Eyes With Intermediate, Posterior, or Panuveitis Followed up to 10 Years After Randomization to Fluocinolone Acetonide Implant or Systemic Therapy.

John H Kempen, Mark L Van Natta, David S Friedman, Michael M Altaweel, Husam Ansari, James P Dunn, Susan G Elner, Janet T Holbrook, Lyndell L Lim, Elizabeth A Sugar and 2 more

Open access · greenAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in American journal of ophthalmology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.5field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 14 citations in OpenAlex.

  1. Review
  2. Article
  3. Safe Use of Corticosteroids in Non-Infectious Uveitis.Journal of inflammation research · 2025
    Review
  4. Article
  5. Update on Diagnosis and Treatment of Uveitic Glaucoma.Journal of clinical medicine · 2024
    Review
  6. Article
  7. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 7 institutions in 3 countries.

John H KempenDepartment of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USA; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA; The MyungSung Christian Medical Center (MCM) Eye Unit, MCM General Hospital and MyungSung Medical School, Addis Ababa, Ethiopia. Electronic address: john_kempen@meei.harvard.edu.
Mark L Van NattaCenter for Clinical Trials and Evidence Synthesis, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
David S FriedmanDepartment of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USA.
Michael M AltaweelFundus Photograph Reading Center, Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA.
Husam AnsariOphthalmology Consultants of Boston, Boston, Massachusetts, USA.
James P DunnMid-Atlantic Retina, Philadelphia, Pennsylvania, USA; The Wills Eye Hospital, Philadelphia, Pennsylvania, USA.
Susan G ElnerThe Kellogg Eye Center, Department of Ophthalmology, University of Michigan, Ann Arbor, Michigan, USA.
Janet T HolbrookCenter for Clinical Trials and Evidence Synthesis, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Lyndell L LimThe Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
Elizabeth A SugarCenter for Clinical Trials and Evidence Synthesis, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Biostatistics, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Douglas A JabsCenter for Clinical Trials and Evidence Synthesis, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; The Johns Hopkins University School of Medicine Wilmer Eye Institute, Baltimore, Maryland, USA.
Multicenter Uveitis Steroid Treatment (MUST) Trial and Follow-up Study Research Group
Johns Hopkins University · USMassachusetts Eye and Ear Infirmary · USOphthalmology Consultants · USThe Royal Victorian Eye & Ear Hospital · AUUniversity of Wisconsin–Madison · USWills Eye Hospital · USW.K. Kellogg Foundation · US

Funding

Multi-Center Uveitis Steriod Treatment (MUST) TrialU10EY014660 · NEI · JOHNS HOPKINS UNIVERSITY · PI HOLBROOK, JANET T. · 2004 to 2016
$33.6M
ADalimumab Vs. conventional ImmunoSupprEssion for uveitis(ADVISE) TrialUG1EY028091 · NEI · JOHNS HOPKINS UNIVERSITY · PI HOLBROOK, JANET T., SUGAR, ELIZABETH ANN · 2018 to 2022
$9.0M
Multicenter Uveitis Steroid Treatment (MUST) TrialU10EY014655 · NEI · JOHNS HOPKINS UNIVERSITY · PI JABS, DOUGLAS A · 2004 to 2016
$4.6M
Reading Center: Multicenter Uveitis Steroid TrialU10EY014656 · NEI · UNIVERSITY OF WISCONSIN-MADISON · PI ALTAWEEL, MICHAEL M · 2004 to 2015
$2.2M
NEI NIH HHS U10 EY014655NEI NIH HHS U10 EY014656NEI NIH HHS U10 EY014660NEI NIH HHS UG1 EY028091
6 · The paper itself

Abstract

purposeTo evaluate long-term risk and outcomes of glaucoma in eyes with intermediate, posterior, and panuveitis managed with systemic or fluocinolone acetonide (0.59 mg, "implant") therapy.

designProspective Follow-up of the Multicenter Uveitis Steroid Treatment (MUST) Clinical Trial Cohort.

methodsPatients with intermediate, posterior, or panuveitis randomized to implant or systemic therapy (corticosteroid plus immunosuppression in >90%) were followed prospectively for glaucoma incidence and outcome.

resultsAmong 405 uveitic at-risk eyes of 232 patients (median follow-up = 6.9 years), 40% (79/196) of eyes assigned and treated with implant and 8% (17/209) of eyes assigned and treated with systemic therapy (censoring eyes receiving an implant on implantation) developed glaucoma (hazard ratio [HR] = 5.9, 95% confidence interval [CI] 3.2, 10.8; P < .001). Adjustment for intraocular pressure (IOP) elevation during follow-up only partially mitigated the association of implant treatment with glaucoma incidence: HR = 3.1 (95% CI 1.6, 6.0); P = .001. Among 112 eyes of 83 patients developing glaucoma, the 5-year cumulative incidence following diagnosis of sustained (2 or more consecutive visits) worsening of mean deviation by ≥6 dB was 20% (95% CI 12%, 33%); 5-year cumulative incidence of sustained worsening of cup-to-disc ratio by ≥0.2 was 26% (95% CI 17%, 39%).

conclusionsThe implant has substantially higher risk of glaucoma than systemic therapy, a difference not entirely explained by posttreatment IOP elevation. Management of IOP elevation was effective in preventing worsening of glaucoma for the large majority of cases, but even under expert clinical management, some glaucoma worsened. Uveitis cases should be monitored carefully for IOP elevation and glaucoma indefinitely.

Indexed as

AdultDrug ImplantsFemaleFluocinolone AcetonideFollow-Up StudiesGlaucomaGlucocorticoidsHumansIncidenceIntraocular PressureMaleMiddle AgedPanuveitisProspective StudiesRisk FactorsTreatment OutcomeDrug ImplantsFluocinolone AcetonideGlucocorticoids

Identifiers

PMID32628922
PMCPMC7606748
OpenAlexW3038766980

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.