Ocular hypertension and uveitis: about 103 cases of uveitis

Abstract

Purpose To determine the prevalence of intraocular hypertension (IOH) in 103 patients referred for uveitis in a tertiary care centre. Methods 103 consecutive patients referred to our department for uveitis were included. Files were retrospectively analyzed for age at time of presentation, gender, type of uveitis (as definedy by International Uveitis Study Group) and etiology, time of IOH (primary or secondary to treatment) and filtering surgical procedure associated. IOP was measured using Goldmann aplanation tonometry and IOH was defined as intraocular pressure ≥ 21mmHg. Results Among all patients, 36% of uveitis were related to a concomitant infectious disease (herpetic disease in 20% of cases and herpes‐zoster in 4%). No significant difference on age, gender was found between all 103 cases of uveitis. At least on episode of IOH was found during the acute phase of the disease in 27 patients (26.2%): anterior uveitis represented 74% of patients. Most of hypertensive cases were associated to herpetic disease (37%), than undetermined etiology in 6 patients (22%), toxoplasmosis uveitis in 2 patients (7,4%). Topical steroids and IOH were associated in 2 patients (7,4%). The IOH was controlled by topical hypotensive treatment in 74,1% of patients, and a filtering surgical procedure was found necessary in 7 patients (25,9%). Conclusion This retrospective study confirms that IOH is a major complication of uveitis, especially in those involving the anterior chamber of the eye and/or related to viruses. Most of cases responded rapidly to combined topical steroids / antiglaucomatous therapy.

Clinical Outcome of Hypertensive Uveitis

“…These results are more in accordance with other reports where a frequency from 14 to 42% of glaucoma was found in JIA [ 20 – 27 ]. The distribution of the other causes of uveitis is in agreement with previous reports [ 28 ]. We found 22.95% of anterior herpetic uveitis.…”

“…We found 22.95% of anterior herpetic uveitis. This is slightly less than other reports where 28 to 45% of elevated IOP was found [ 28 , 29 ].…”

“…To our knowledge, our study is the first one to evaluate the etiologies of uveitis among a group of hypertensive uveitis and to compare viral and nonviral uveitis, while most previous studies investigated elevated IOP among groups of patients with a specific etiology of uveitis [ 6 , 10 , 20 , 21 , 27 , 28 ]. We found demographic differences between viral and nonviral uveitis.…”

Anterior segment optical coherence tomography in acute anterior uveitis

“…In severe cases, it can be associated with increased intraocular pressure (IOP) (1) . Open-angle or closed-angle glaucoma have been described in 20% uveitis cases (3) , and ocular hypertension is considered an important complication of uveitis, particularly when it involves the anterior ocular segment (4) . The corneal involvement during uveitis remains understudied, although the cornea is probably a target of intraocular inflammation (2) .…”

Herpes Zoster Ophthalmicus—Diagnosis and Management

“…Secondary inflammatory hypertony and glaucoma may occur and may have several underlying mechanisms: 1) trabeculitis, 2) trabecular meshwork blockage by cellular debris, pigment, blood, 3) pupillary block from posterior synechiae, or 4) extensive peripheral anterior synechiae. 4,19,41,42 iritis arises from an ischemic occlusive vasculitis and typically results in sectorial iris atrophy (see Figure 4), a feature that is often useful for the retrospective diagnosis of a VZV (or HSV) related episode of intraocular inflammation. 12,43 VZV necrotizing retinitis is a rare but disastrous complication.…”