Article Text

Download PDFPDF
High rate of conversion from ocular hypertension to glaucoma in subjects with uveitis
  1. Tiffany Ma1,
  2. Joanne L Sims1,
  3. Sonya Bennett1,
  4. Shenton Chew1,
  5. Rachael L Niederer1,2
  1. 1Department of Ophthalmology, Auckland District Health Board, Auckland, New Zealand
  2. 2Department of Ophthalmology, University of Auckland, Auckland, New Zealand
  1. Correspondence to Dr Rachael L Niederer, Ophthalmology, Greenlane Clinical Centre, Auckland 1051, New Zealand; dr_rachnz{at}yahoo.co.nz

Abstract

Aims To examine presentation, management and long-term sequelae of ocular hypertension and uveitic glaucoma.

Methods Retrospective observational study of all subjects with uveitic glaucoma or ocular hypertension seen in Auckland uveitis clinics over the last 10 years.

Results A total of 188 eyes of 139 subjects with uveitic glaucoma or ocular hypertension were included for analysis. Total follow-up was 1854.5 eye years (mean 9.9 years). The mean age at uveitis diagnosis was 49.3 years. 52.5% of subjects were male. The most common diagnoses were idiopathic uveitis (29.3%), sarcoidosis (13.3%), herpes zoster (6.9%), HLA-B27 uveitis (6.9%), tuberculosis (5.9%) and Posner-Schlossmann or cytomegalovirus (CMV) uveitis (5.3%). Median intraocular pressure (IOP) at diagnosis was 35 mm Hg (IQR 29–45). 144 eyes (77.0%) developed glaucoma during the follow-up period, of whom 41 lost some central vision due to glaucoma. Oral acetazolamide was required for IOP control in 64.5%, 50 eyes underwent trabeculectomy, 18 eyes required a tube and 6 underwent minimally invasive glaucoma surgery.

Conclusion Rapid progression was observed from ocular hypertension to uveitic glaucoma. Uveitic glaucoma is aggressive, with high likelihood of requiring surgical management and high risk of central vision loss. Close collaboration between uveitis and glaucoma specialists is required to maximise outcomes for these patients.

  • treatment surgery
  • treatment medical
  • inflammation
  • glaucoma
  • infection

Data availability statement

No data are available. Ethics approval does not allow data sharing.

Statistics from Altmetric.com

Data availability statement

No data are available. Ethics approval does not allow data sharing.

View Full Text

Footnotes

  • Contributors RLN: principal investigator with overall responsibility for study, study design, data analysis and interpretation, drafting and revising manuscript. TM: responsible for data collection, drafting and revising manuscript. All authors contributed to study design, interpretation of results and drafting and revising the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.