Ellen N Yu1, Ian Paredes, C Stephen Foster. 1. Massachusetts Eye Research & Surgery Institute, Ocular Immunology and Uveitis Foundation, Harvard Medical School, Cambridge, MA 02142, USA.
Abstract
PURPOSE: To describe the clinical response to cyclitic membrane excision of eyes with juvenile idiopathic arthritis (JIA)-associated uveitis and hypotony. METHODS: The clinical records of patients with JIA-associated uveitis in a tertiary referral center were reviewed. Those patients with JIA-associated uveitis and hypotony who underwent cyclitic membrane excision were included in the study. Patients with hypotony secondary to active inflammation, retinal detachment, and surgical intervention (filtering, cyclo-destructive procedures, and glaucoma valve implantation) were excluded. RESULTS: Two pediatric and two adult patients (4 eyes) were identified. The range of pre-operative intraocular pressure (IOP) was 0-5 mmHg. The two adult patients were noted to have atrophic ciliary processes intra-operatively, while the two pediatric patients had normal ciliary processes. At six months follow-up, the adult patients had IOPs of 5 mmHg, while the two pediatric patients had IOPs of 16 mmHg. At last consultation (mean duration of follow-up: 3.6 years), IOP was normal in all eyes. None of the eyes had a decrease in vision. CONCLUSIONS: Release of traction on the ciliary body by inflammatory membranes may play a role in the management of hypotony in patients with JIA-associated uveitis. However, even though the IOP was successfully elevated, preventing phthisis, vision remained poor due to the long-standing complications secondary to chronic uveitis. This emphasizes the critical importance of early diagnosis and appropriate treatment of the inflammation before vision-robbing complications occur.
PURPOSE: To describe the clinical response to cyclitic membrane excision of eyes with juvenile idiopathic arthritis (JIA)-associated uveitis and hypotony. METHODS: The clinical records of patients with JIA-associated uveitis in a tertiary referral center were reviewed. Those patients with JIA-associated uveitis and hypotony who underwent cyclitic membrane excision were included in the study. Patients with hypotony secondary to active inflammation, retinal detachment, and surgical intervention (filtering, cyclo-destructive procedures, and glaucoma valve implantation) were excluded. RESULTS: Two pediatric and two adult patients (4 eyes) were identified. The range of pre-operative intraocular pressure (IOP) was 0-5 mmHg. The two adult patients were noted to have atrophic ciliary processes intra-operatively, while the two pediatric patients had normal ciliary processes. At six months follow-up, the adult patients had IOPs of 5 mmHg, while the two pediatric patients had IOPs of 16 mmHg. At last consultation (mean duration of follow-up: 3.6 years), IOP was normal in all eyes. None of the eyes had a decrease in vision. CONCLUSIONS: Release of traction on the ciliary body by inflammatory membranes may play a role in the management of hypotony in patients with JIA-associated uveitis. However, even though the IOP was successfully elevated, preventing phthisis, vision remained poor due to the long-standing complications secondary to chronic uveitis. This emphasizes the critical importance of early diagnosis and appropriate treatment of the inflammation before vision-robbing complications occur.
Authors: H Nida Sen; Lea T Drye; Debra A Goldstein; Theresa A Larson; Pauline T Merrill; Peter R Pavan; John D Sheppard; Alyce Burke; Sunil K Srivastava; Douglas A Jabs Journal: Ocul Immunol Inflamm Date: 2012-04 Impact factor: 3.070
Authors: Rosa Bou; Alfredo Adán; Fátima Borrás; Beatriz Bravo; Inmaculada Calvo; Jaime De Inocencio; Jesús Díaz; Julia Escudero; Alex Fonollosa; Carmen García de Vicuña; Victoria Hernández; Rosa Merino; Jesús Peralta; María-Jesús Rúa; Pilar Tejada; Jordi Antón Journal: Rheumatol Int Date: 2015-02-06 Impact factor: 2.631