Clinical Outcome of Hypertensive Uveitis

The BGI is an effective and safe treatment for patients with refractive secondary glaucoma due to uveitis. In a majority of patients, VA remains stable and a low and stable IOP is maintained over time with an acceptable number of complications. In particular, patients with viral uveitis and glaucoma should be closely monitored for IOP peaks that may occur during episodes of a flare-up of uveitis, whereas at the other end of the spectrum, patients with JIA seem much more prone to hypotony maculopathy.

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“…Lewkowicz et al. () also reported higher IOP in patients with viral uveitis compared to nonviral uveitis.…”

Section: Discussionmentioning

confidence: 90%

Outcomes of severe uveitic glaucoma treated with Baerveldt implant: can blindness be prevented?

Tan

Cornelissen

Webers

et al. 2017

Acta Ophthalmologica

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“…2 Viral agents were repeatedly detected in the intraocular fluid of patients with AU, especially in patients with unilateral hypertensive anterior uveitis (HAU), who were resistant to standard topical treatment with corticosteroids. 3,4 Multiple viral causes of AU were reported, the most common being members of the herpes virus group. Rubella virus (RV) was demonstrated in Europe and other countries and emerging viral agents as chikungunya, Zika, and Ebola viruses were also implicated.…”

mentioning

confidence: 99%

Causes of Hypertensive Anterior Uveitis in Thailand

Khieu

Kongyai

Pathanapitoon

et al. 2019

Ocular Immunology and Inflammation

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Purpose: To determine the prevalence of viral infections in patients with hypertensive anterior uveitis in Thailand from polymerase chain reaction (PCR) of aqueous humor. Methods: Thirty-one patients with anterior uveitis with intraocular pressure (IOP) above 25 mmHg were included for PCR analysis for cytomegalovirus (CMV), herpes simplex (HSV), varicella-zoster (VZV), rubella, chikungunya and Zika virus. Results: The prevalence of PCR-positive results was 32%, including 19% for CMV, 10% for HSV, and 3% for VZV; PCR for other tested viruses demonstrated negative results. PCR-positive patients exhibited satisfactory IOP control with antiviral and anti-glaucomatous treatment compared to PCR-negative patients, and more than half of PCR-negative patients required glaucoma surgery within 12 months (P = .01). Conclusion: PCR evidence of infection with herpes group viruses was found in one-third of patients with hypertensive anterior uveitis; CMV being the most common pathogen. The PCR-positive group generally responded well to a combination of antiviral and anti-glaucoma treatment.

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“…10 Glaucoma-associated uveitis was diagnosed when patients developed characteristic optic nerve cupping with corresponding glaucomatous visual field defect on automated Humphrey visual field (HVF) testing and defects in OCT RNFL as previously described. 3 The number and type of anti-glaucomatous medications were recorded as well as the number and type of glaucoma surgery.…”

Section: Methodsmentioning

confidence: 99%

“…PCR and GWc analysis are complementary for the diagnosis of infectious uveitis. [2][3][4][5] By performing these diagnostic methods, it has recently been shown that cytomegalovirus (CMV), a member of the Herpesviridae family, can be responsible for an AU in immunocompetent individuals. 6,7 A range of clinical presentations of CMV AU, has since been described, varying from recurrent iritis with raised intraocular pressure (IOP) resembling Posner-Schlossman syndrome (PSS), to chronic anterior uveitis mimicking Fuchs uveitis syndrome (FUS), both patterns that may be accompanied by corneal endotheliitis.…”

mentioning

confidence: 99%