PURPOSE-To evaluate the risk of and risk factors for hypopyon among patients with uveitis, and to evaluate the risk of visual changes and structural complications following hypopyon.
DESIGN-Retrospective cohort study.PARTICIPANTS-Patients with uveitis at four academic ocular inflammation subspecialty practices.
METHODS-Data were ascertained by standardized chart review.MAIN OUTCOME MEASURES-Prevalence and incidence of hypopyon, risk factors for hypopyon, and incidence of visual acuity changes and of structural ocular complications following hypopyon.RESULTS-Among 4,911 patients with uveitis, 41 (8.3/1000) cases of hypopyon were identified at the time of cohort entry. Of these, 2,885 initially free of hypopyon were followed over 9,451 person-years, during which 81 (2.8%) developed hypopyon (8.57/1000 person-years). Risk factors Corresponding Author: John H. Kempen, M.D., Ph.D.; Center for Preventive Ophthalmology and Biostatistics; Department of Ophthalmology; University of Pennsylvania; 3535 Market Street, Suite 700; Philadelphia, PA 19104 john.kempen@uphs.upenn.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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Author ManuscriptOphthalmology. Author manuscript; available in PMC 2011 February 1.
Published in final edited form as:Ophthalmology. CONCLUSIONS-Hypopyon is an uncommon occurrence in patients with uveitis. Risk factors included Behçet's disease, HLA-B27 positivity, and diagnosis of a spondyloarthropathy. Intermediate uveitis cases (+/− anterior uveitis) had lower risk of hypopyon than other forms of uveitis. On average, post-hypopyon eyes were no more likely than other eyes with uveitis to develop structural ocular complications or lose visual acuity.Hypopyon-layering of white blood cells in the anterior chamber-signifies severe anterior segment intraocular inflammation. The frequency of hypopyon has been described in two small to moderate-sized series of patients with various types of uveitis. D'Alessandro et al retrospectively reviewed 155 cases of acute anterior uveitis and found 11 (7%) cases of hypopyon (duration of follow-up not reported), 9 of which were associated with HLA-B27. 1 BenEzra et al reviewed 49 patients with Behçet's disease, finding that 17 (35%) developed hypopyon over 6-10 years of follow-up.2 The incidence of hypopyon for other forms of uveitis is unclear.Data regarding the risk factors for hypopyon and regarding its prognostic significance are limited. Nussenblatt et al reported that the occurrence of hypopyon did not worsen the visual prognosis of patients with Behçet's disease. 3 However, the relationship betw...