Retinal vasculitis has a chronic and unpredictable course, warranting long-term follow-up to detect late bilateral involvement and recurrence; recurrence becomes less frequent over time but may still occur after many years, and most patients continue to have idiopathic disease without subsequent identification of a systemic cause.
The cohort of 37 retinal vasculitis patients with at least 30 years of follow-up was predominantly young adult males.
Involvement was bilateral in just over half of patients, and some initially unilateral cases developed disease in the fellow eye later.
Presumed tuberculosis was diagnosed in only five patients, and no other patient developed ocular or extraocular tuberculosis over 30 years.
Treatment relied mainly on oral corticosteroids and photocoagulation, with low use of immunosuppressives and anti-VEGF.
Glaucoma, vitreous hemorrhage, and optic neuropathy were the most common complications.
Inflammation recurred in nearly one-third of eyes over three decades, and a substantial number of eyes needed surgery.
Visual outcomes after 30 years showed modest average improvement, with improvement in 41.9% of eyes but deterioration in 33.9%.
This study looked back at the records of 37 people treated for retinal vasculitis (inflammation of the blood vessels in the retina) at a large eye hospital in India, all of whom were followed for at least 30 years (average about 34 years). Almost all were men, and they were on average in their early 30s when the disease began. About half had both eyes affected, and a few who started with one affected eye later developed it in the other. Over the decades, common problems included glaucoma, bleeding inside the eye, and optic nerve damage. Inflammation came back in about 30% of eyes, and some eyes needed surgery for retinal problems. Treatment was mostly steroid tablets and laser therapy. Vision on average improved slightly: about 42% of eyes got better, 24% stayed the same, and 34% got worse. Only five people were thought to have tuberculosis as the cause, and nobody else later developed tuberculosis; in most people no underlying cause was found. This research suggests that retinal vasculitis can be a long-lasting and unpredictable condition, with possible late involvement of the second eye and recurrences even after many years. It supports the value of long-term eye follow-up. Because this was a retrospective study of a small group at one center, the findings may not apply to everyone with the condition.
Sen A, Manna G, George A, Ganesh S, Biswas J, Dutta Majumder P. (2026). Thirty-year follow-up of retinal vasculitis at a tertiary eye care center in India.. Indian journal of ophthalmology. https://doi.org/10.4103/IJO.IJO_977_26