Clinical Characteristics of Posner‐Schlossman Syndrome Patients in China

Abstract

Background. To explore the clinical characteristics of Posner-Schlossman syndrome (PSS) patients in China, especially the risk factors associated with the dynamic changes of corneal endothelial cell (CEC) density and retinal nerve fiber layer (RNFL) thickness during the course of the disease. Methods. In this retrospective cohort study, patients consequently suffering from PSS were recruited. Patients data including gender, age of onset, frequency of attack, and disease duration. We performed detailed ophthalmology examinations including intraocular pressure (IOP), best-corrected visual acuity (BCVA), slit-lamp examination, optical coherence tomography (OCT), assessing RNFL thickness, and determined CEC density in the outpatient department. The unaffected eyes served as control. Results. We recruited 121 patients (eyes, n = 125 ), including 69 (57.0%) males and 52 (43.0%) females with Posner-Schlossman syndrome. The age of first-onset was 33.81 ± 13.63 years old. The majority of these patients were aged 20-50 years (80.2%). The peak IOP was 47.67 ± 13.31 mmHg in the affected eyes. The frequency of PSS attack was 2.7 ± 3.7 times per year. The disease duration was 9.5 ± 10.4 years. Among all patients, there were 27 (22.31%) patients with a history of digestive disorders, 25 (20.66%) patients with a history of allergies, and 24 (19.83%) patients with a history of infectious disease. In the affected eyes, CEC density ( 2532.94 ± 490.83 /mm2 vs. 2777.13 ± 356.87 /mm2, p < 0.001 ), the RNFL thickness of four quadrants (superior 105.46 ± 29.86 μm vs. 121.33 ± 17.30 μm, p < 0.001 ; temporal 74.58 ± 22.21 μm vs. 81.94 ± 18.20 μm, p = 0.009 ; inferior 110.50 ± 33.42 μm vs. 128.29 ± 14.39 μm, p < 0.001 ; nasal 54.85 ± 14.48 μm vs. 63.49 ± 15.40 μm, p < 0.001 ) and central papillary ( 87.11 ± 21.18 μm vs. 99.18 ± 7.97 μm, p < 0.001 ) were significantly reduced compared to the fellow eyes. The disease duration and recurrent frequency were significantly associated with CEC density ( p < 0.001 and p = 0.029 ) and the disease duration was significantly associated with RNFL thickness ( p = 0.002 ). Conclusions. In this study, CEC loss and RNFL thinning were present in the affected eyes. Our results indicated that disease duration and recurrent frequency played an important role in the progression of PSS.

Early changes of ganglion cell-inner plexiform layer thickness and macular microvasculature in Posner-Schlossman syndrome: a binocular control study by OCTA

“…Accordingly, the average course of disease in our patients was 3.39 ± 6.56 years, while was significantly shorter than 9.5 ± 10.4 years in Gao's study (36). The selection bias and a relatively small sample size may be responsible for the different results in our study from previous studies (5,36). A longitudinal study with larger sample size is needed to further investigate the influencing factors on the progression of PSS.…”

“…Jap et al ( 5 ) held that disease duration was the only factor leading to glaucomatous optic nerve injury in PSS. Gao et al ( 36 ) showed that both the duration of the disease and the frequency of attacks affected the progression of PSS. However, we could not find the correlation between disease duration or disease frequency and the wiVD or wiPD in our study.…”

“…The most important reason may be due to the different inclusion criteria in our research. We only selected patients with early visual field defects, excluding patients with middle and late visual field defects, or patients underwent glaucoma filtering surgery, which is different from the sample selection in the above paper ( 5 , 36 ). Accordingly, the average course of disease in our patients was 3.39 ± 6.56 years, while was significantly shorter than 9.5 ± 10.4 years in Gao’s study ( 36 ).…”

“…We only selected patients with early visual field defects, excluding patients with middle and late visual field defects, or patients underwent glaucoma filtering surgery, which is different from the sample selection in the above paper ( 5 , 36 ). Accordingly, the average course of disease in our patients was 3.39 ± 6.56 years, while was significantly shorter than 9.5 ± 10.4 years in Gao’s study ( 36 ). The selection bias and a relatively small sample size may be responsible for the different results in our study from previous studies ( 5 , 36 ).…”

Clinical profile, demographic distribution, and management of Posner–Schlossman syndrome: An electronic medical record-driven data analytics from an eye care network in India

“…It has been hypothesized that mild inflammation does keep recurring, which goes undetected, leading to optic nerve damage and retinal nerve fiber layer (RNFL) thinning. [ 36 ] Therefore, it can be rationalized that continuation of glaucoma medications is important in patients who show glaucomatous optic nerve damage, those with a large cup: disc ratio, or focal thinning of neuroretinal rim,[ 10 24 ] with some even advocating to continue medications in those at risk of NAION, as cases of NAION post PSS have been reported. [ 37 ]…”