PURPOSE: To compare the management and outcome of raised intraocular pressure (IOP) in uveitis patients with a corticosteroid hypertensive response and those who are noncorticosteroid responders and to determine the impact of intraocular corticosteroid use on IOP in uveitic eyes. DESIGN: Retrospective study. METHODS: Eight hundred and ninety-one uveitis patients were observed in a specialized clinic over 3 months. The main outcome measures were frequency, characterization, management, and outcome of uveitis-related ocular hypertension and glaucoma. RESULTS: Of 891 patients with uveitis, 191 (275 eyes) had IOP elevation (21.4%). Of these, 95 (34.5%) eyes had glaucoma. IOP elevation attributed to corticosteroid-response (61.1%) was controlled more easily than that resulting from other causes (38.9%), requiring fewer eye drops (mean, 2.06 vs 2.52; P = .009) and less filtration surgery (8.9% vs 22.4%). Among eyes with uveitis and raised IOP, elevated IOP developed in 18 eyes (6.5%) after intravitreal triamcinolone, including 64.7% to 30 to 39 mm Hg and 35.3% to 40 mm Hg or more. Prostaglandin analogs were used in 49.2% of 246 eyes; no increase in inflammation was seen in these eyes. CONCLUSIONS: In this tertiary center series, most instances of raised IOP were attributable to corticosteroid response. Raised IOP induced by corticosteroid response was controlled more easily and less often resulted in optic nerve or visual field changes of glaucoma. Although intravitreous triamcinolone was associated with substantial risk of corticosteroid-response IOP elevation, all cases were controlled medically without experiencing glaucomatous injury. Prostaglandin-induced uveitis was not observed despite extensive use of prostaglandin IOP-lowering agents.
PURPOSE: To compare the management and outcome of raised intraocular pressure (IOP) in uveitispatients with a corticosteroid hypertensive response and those who are noncorticosteroid responders and to determine the impact of intraocular corticosteroid use on IOP in uveitic eyes. DESIGN: Retrospective study. METHODS: Eight hundred and ninety-one uveitispatients were observed in a specialized clinic over 3 months. The main outcome measures were frequency, characterization, management, and outcome of uveitis-related ocular hypertension and glaucoma. RESULTS: Of 891 patients with uveitis, 191 (275 eyes) had IOP elevation (21.4%). Of these, 95 (34.5%) eyes had glaucoma. IOP elevation attributed to corticosteroid-response (61.1%) was controlled more easily than that resulting from other causes (38.9%), requiring fewer eye drops (mean, 2.06 vs 2.52; P = .009) and less filtration surgery (8.9% vs 22.4%). Among eyes with uveitis and raised IOP, elevated IOP developed in 18 eyes (6.5%) after intravitreal triamcinolone, including 64.7% to 30 to 39 mm Hg and 35.3% to 40 mm Hg or more. Prostaglandin analogs were used in 49.2% of 246 eyes; no increase in inflammation was seen in these eyes. CONCLUSIONS: In this tertiary center series, most instances of raised IOP were attributable to corticosteroid response. Raised IOP induced by corticosteroid response was controlled more easily and less often resulted in optic nerve or visual field changes of glaucoma. Although intravitreous triamcinolone was associated with substantial risk of corticosteroid-response IOP elevation, all cases were controlled medically without experiencing glaucomatous injury. Prostaglandin-induced uveitis was not observed despite extensive use of prostaglandin IOP-lowering agents.
Authors: Ebenezer Daniel; Maxwell Pistilli; Srishti Kothari; Naira Khachatryan; R Oktay Kaçmaz; Sapna S Gangaputra; H Nida Sen; Eric B Suhler; Jennifer E Thorne; C Stephen Foster; Douglas A Jabs; Robert B Nussenblatt; James T Rosenbaum; Grace A Levy-Clarke; Nirali P Bhatt; John H Kempen Journal: Ophthalmology Date: 2017-04-19 Impact factor: 12.079
Authors: Sapna S Gangaputra; Michael M Altaweel; Qian Peng; David S Friedman; P Kumar Rao; C Stephen Foster; Rosa Y Kim; Susan B Reed; Sunil K Srivastava; Ira G Wong; John H Kempen Journal: Ocul Immunol Inflamm Date: 2011-08 Impact factor: 3.070
Authors: David S Friedman; Janet T Holbrook; Husam Ansari; Judith Alexander; Alyce Burke; Susan B Reed; Joanne Katz; Jennifer E Thorne; Susan L Lightman; John H Kempen Journal: Ophthalmology Date: 2013-04-16 Impact factor: 12.079
Authors: H Nida Sen; Susan Vitale; Sapna S Gangaputra; Robert B Nussenblatt; Teresa L Liesegang; Grace A Levy-Clarke; James T Rosenbaum; Eric B Suhler; Jennifer E Thorne; C Stephen Foster; Douglas A Jabs; John H Kempen Journal: Ophthalmology Date: 2014-07-11 Impact factor: 12.079