N Saouli1, A P Brézin. 1. Service d'Ophtalmologie, Hôpital Cochin, Paris.
Abstract
OBJECTIVES: To study the frequency of ocular hypertension in uveitis and its correlations with the characteristics of uveitis. To analyze the mechanisms of hypertension and the influence of different etiologies. To evaluate the prognosis of increased intraocular pressure secondary to uveitis. MATERIAL AND METHODS: Retrospective, single-center, mono-observer study of 374 consecutive cases of uveitis. RESULTS: Ocular hypertension was observed in 45 of 374 cases (12%). Hypertension was observed only in 2 cases without any sign of anterior chamber inflammation. Increased intraocular pressure was more frequently observed in granulomatous uveitis [15 of 33 cases (45.4%)] than in non granulomatous uveitis [30 of 341 cases (8.9%)] (p < 0.001). There were 2 cases of Posner-Schlossman syndrome. Herpetic uveitis was otherwise the most frequent etiology of uveitis associated with secondary ocular hypertension [8 of 22 cases (36.3%)]. The ocular hypertension was most often in phase with intraocular inflammation [17 of 45 cases (37.8%)], suggesting a mechanism of trabecular obstruction. Corticosteroid-induced hypertension was only noted in 2 cases. In 12 cases the mechanisms of ocular hypertension could not be determined. Glaucomatous optic neuropathy was only observed in 3 patients. Filtering surgery was performed in 4 cases. CONCLUSIONS: Among uveitis cases, findings linked to a higher frequency of ocular hypertension were identified. There was a discrepancy between the low frequency of corticosteroid induced hypertension and the broad use of topical corticosteroids in cases of uveitis. The analysis of the mechanisms involved is necessary for an adequate treatment. The prognosis of hypertensive uveitis was more frequently linked to the consequences of intraocular inflammation than to hypertension.
OBJECTIVES: To study the frequency of ocular hypertension in uveitis and its correlations with the characteristics of uveitis. To analyze the mechanisms of hypertension and the influence of different etiologies. To evaluate the prognosis of increased intraocular pressure secondary to uveitis. MATERIAL AND METHODS: Retrospective, single-center, mono-observer study of 374 consecutive cases of uveitis. RESULTS:Ocular hypertension was observed in 45 of 374 cases (12%). Hypertension was observed only in 2 cases without any sign of anterior chamber inflammation. Increased intraocular pressure was more frequently observed in granulomatous uveitis [15 of 33 cases (45.4%)] than in non granulomatous uveitis [30 of 341 cases (8.9%)] (p < 0.001). There were 2 cases of Posner-Schlossman syndrome. Herpetic uveitis was otherwise the most frequent etiology of uveitis associated with secondary ocular hypertension [8 of 22 cases (36.3%)]. The ocular hypertension was most often in phase with intraocular inflammation [17 of 45 cases (37.8%)], suggesting a mechanism of trabecular obstruction. Corticosteroid-induced hypertension was only noted in 2 cases. In 12 cases the mechanisms of ocular hypertension could not be determined. Glaucomatous optic neuropathy was only observed in 3 patients. Filtering surgery was performed in 4 cases. CONCLUSIONS: Among uveitis cases, findings linked to a higher frequency of ocular hypertension were identified. There was a discrepancy between the low frequency of corticosteroid induced hypertension and the broad use of topical corticosteroids in cases of uveitis. The analysis of the mechanisms involved is necessary for an adequate treatment. The prognosis of hypertensive uveitis was more frequently linked to the consequences of intraocular inflammation than to hypertension.