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Elevated intraocular pressure in uveitis associated with juvenile idiopathic arthritis-associated uveitis, often detected after achieving inactivity
  1. Carsten Heinz1,2,
  2. Claudia Schumacher1,
  3. Martin Roesel1,
  4. Arnd Heiligenhaus1,2
  1. 1Department of Ophthalmology, St. Franziskus-Hospital, Münster, Germany
  2. 2Department of Ophthalmology, University of Duisburg, Essen, Germany
  1. Correspondence to Dr Carsten Heinz, Department of Ophthalmology, St. Franziskus-Hospital Münster, Hohenzollernring 74, Münster 48145, Germany; carsten.heinz{at}uveitis-zentrum.de

http://dx.doi.org/10.1136/bjophthalmol-2011-300731

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    In patients with juvenile idiopathic arthritis (JIA)-associated anterior uveitis, secondary open angle glaucoma and ocular hypertension frequently develop during the clinical course of disease.1 Appropriate topical antiglaucomatous treatment should be started immediately after diagnosis in order to prevent the occurrence of irreversible optic neuropathy. The main underlying causes of elevated intraocular pressure (IOP) include congestion of the trabecular meshwork due to cells and debris and morphological changes in the outflow pathway.2 As screening for glaucoma in these patients can be challenging due to their young age, it is helpful to know when elevated IOP first occurred with respect to disease activity.

    Patients and methods

    We retrospectively analysed the time of occurrence of elevated IOP in 30 JIA patients during the course of uveitis. Groups were defined as (1) during inactivity of inflammation (≤0.5 anterior chamber cells according to the Standardization of Uveitis Nomenclature classification),3 (2) during acute inflammation or (3) after intraocular surgery. IOP was measured by Goldmann applanation tonometry. The first instance of elevated IOP was documented if IOP was ≥24 mm Hg at two consecutive measurements. All …

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    Footnotes

    • Competing interests None.

    • Provenance and peer review Not commissioned; externally peer reviewed.