Predictors of uveitic macular edema and functional prognostic outcomes: real-life data from the International AIDA Network Uveitis Registry

Jurgen Sota¹Germán Mejía-Salgado²Silvana Guerriero³Gaafar Ragab⁴Stefania Costi⁵Maria Pia Paroli⁶Andrea Hinojosa-Azaola⁷Giuseppe Lopalco³Luciana Breda⁸Henrique Giardini⁹Alex Fonollosa¹⁰Maria Sole Chimenti¹¹Antonio Vitale¹Carla Gaggiano¹Blanca Aguilar-Barrera²Laura Daniela Rodríguez-Camelo²Guillermo Arturo Guaracha-Basañez⁷Mohamed Tharwat Hegazy⁴Rosanna Dammacco³Valeria Albano³Eduardo Martin-Nares⁷Santiago Espinosa-Lugo²Mahmoud Ghanema⁴Maria Morrone³Saverio La Bella⁸Rafael Alves Cordeiro⁹Francesco Carubbi¹²Alessandro Conforti¹³Piero Ruscitti¹²Ibrahim Almaghlouth¹⁴Rosaria Talarico¹⁵Stefano Gentileschi¹Petros P Sfikakis¹⁶Valeria Caggiano¹Matteo Piga¹⁷Adele Civino¹⁸Francesca Ricci¹⁹Maissa Thabet²⁰Marcello Govoni²¹Abdurrahman Tufan²²Francesca Crisafulli¹⁹Jessica Sbalchiero¹Sulaiman Al-Mayouf¹⁴Angela Mauro²³Soad Hashad²⁴Francesca Minoia²⁵Alma Nunzia Olivieri²⁶Samar Tharwat²⁷Maria Cristina Maggio²⁸Abdelhafeez Moshrif²⁹Gian Domenico Sebastiani³⁰Daniela Opris-Belinski³¹Gulen Hatemi³²Haner Direskeneli³³FATMA ALIBAZ-ONER³³Lampros Fotis¹⁶José Hernández-Rodríguez³⁴Giovanni Conti³⁵Piercarlo Sarzi Puttini²³Ombretta Viapiana³⁶Annarita Giardina³⁷Patrizia Barone³⁸Kalpana Murthy³⁹Rana Amin⁴Perla Ayumi Kawakami-Campo⁷Vishali Gupta⁴⁰Annamaria Iagnocco⁴¹Ali Şahin⁴²Antonella Insalaco⁴³Andrés González-García⁴⁴Ezgi Deniz Batu⁴⁵Ester Carreño⁴⁶Emanuela Del Giudice⁶Cecilia Beatrice Chighizola⁵Fabrizio Conti⁶Alberto Balistreri¹Bruno Frediani¹Luca Cantarini^1*Alejandra de-la-Torre²Claudia Fabiani¹

• ¹University of Siena, Siena, Italy
• ²Universidad del Rosario, Bogotá, Cundinamarca, Colombia
• ³University of Bari Aldo Moro, Bari, Italy
• ⁴Cairo University, Giza, Giza, Egypt
• ⁵Istituto Ortopedico Gaetano Pini, Milan, Lombardy, Italy
• ⁶Sapienza University of Rome, Rome, Lazio, Italy
• ⁷National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, México, Mexico
• ⁸University of Studies G. d'Annunzio Chieti and Pescara, Chieti, Abruzzo, Italy
• ⁹University of São Paulo, São Paulo, Rio Grande do Sul, Brazil
• ¹⁰University of the Basque Country, Bilbao, Basque Country, Spain
• ¹¹University of Rome Tor Vergata, Roma, Lazio, Italy
• ¹²University of L'Aquila, L'Aquila, Abruzzo, Italy
• ¹³Ospedale San Paolo di c, ASL Roma 4,, Civitavecchia, Italy
• ¹⁴King Saud University, Riyadh, Riyadh, Saudi Arabia
• ¹⁵University of Pisa, Pisa, Tuscany, Italy
• ¹⁶National and Kapodistrian University of Athens, Athens, Greece
• ¹⁷University of Cagliari, Cagliari, Sardinia, Italy
• ¹⁸ASL Lecce, Lecce, Apulia, Italy
• ¹⁹University of Brescia, Brescia, Lombardy, Italy
• ²⁰University of Sousse, Sousse, Tunisia
• ²¹University of Ferrara, Ferrara, Emilia-Romagna, Italy
• ²²Gazi University, Ankara, Ankara, Türkiye
• ²³Luigi Sacco Hospital, Milan, Lombardy, Italy
• ²⁴University of Tripoli, Tripoli, Libya
• ²⁵University of Milan, Milan, Lombardy, Italy
• ²⁶University of Campania Luigi Vanvitelli, Caserta, Campania, Italy
• ²⁷Mansoura University, Mansoura, Dakahlia, Egypt
• ²⁸University of Palermo, Palermo, Sicily, Italy
• ²⁹Horus University, Damietta, Egypt
• ³⁰San Camillo Forlanini Hospital, Rome, Lazio, Italy
• ³¹University of Bucharest, Bucharest, Bucharest, Romania
• ³²Division of Rheumatology, Department of Internal Medicine, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Türkiye
• ³³Marmara University, Kadikoy, Istanbul, Türkiye
• ³⁴Hospital Clinic of Barcelona, Barcelona, Catalonia, Spain
• ³⁵BeSep, University of Messina, Messina, Italy
• ³⁶University of Verona, Verona, Veneto, Italy
• ³⁷Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Sicily, Italy
• ³⁸University of Catania, Catania, Sicily, Italy
• ³⁹Prabha Eye Clinic Bangalore, bangalore, India
• ⁴⁰Guru Nanak Eye Centre, New Delhi, National Capital Territory of Delhi, India
• ⁴¹University of Turin, Turin, Piedmont, Italy
• ⁴²Cumhuriyet University, Sivas, Sivas, Türkiye
• ⁴³Bambino Gesù Children's Hospital (IRCCS), Rome, Lazio, Italy
• ⁴⁴University of Alcalá, Alcalá de Henares, Madrid, Spain
• ⁴⁵Hacettepe University, Ankara, Ankara, Türkiye
• ⁴⁶University Hospital Fundación Jiménez Díaz, Madrid, Madrid, Spain

Objectives: To detect factors capable of predicting the development of macular edema (ME) throughout disease course in patients affected by non-infectious uveitis (NIU).Methods: Predictive factors leading to the development of ME were analyzed through regression analysis. The functional impact of ME on best corrected visual acuity (BCVA) was also examined.Results: A total of 1,160 NIU patients (1,857 eyes) were analyzed. ME was observed in 148 (12.76%) affecting 211 eyes. It was significantly more frequent in patients with non-anterior NIU (p<0.0001, RR=4.01), retinal vasculitis (p<0.0001) and other structural complications (p=0.0005). Gender, HLA-B*27 and/or HLA-B*51 positivity, and ethnicity did not show any significant impact in the prevalence of ME (p=0.635, p=0.372, p=0.193, respectively). Four variables were associated with ME development during NIU course: the non–anterior anatomical pattern (p<0.0001, OR = 4.01), the presence of retinal vasculitis (p=0.028, OR = 1.68), complications other than ME (p=0.044, OR = 1.51) and immunosuppressive treatment (p=0.010, OR 1.69) while the diagnosis of Behçet disease-related uveitis was less likely to be associated with ME development (p=0.24, OR 0.545). Mean ± SD BCVA was significantly lower in eyes with ME (0.82 ± 0.30) compared to eyes without ME (0.71 ± 0.33).Conclusion: ME can develop across all NIU types, but is more likely in cases involving the posterior segment and retinal vasculitis. Regular and focused monitoring is recommended for these high-risk patients. The study also highlights the limited predictive value of demographic and HLA-related factors, helping refine clinical risk stratification and predictive modeling in NIU.