Occurrence of and Risk Factors for Ocular Hypertension and Secondary Glaucoma in Juvenile Idiopathic Arthritis-associated Uveitis

Ocul Immunol Inflamm. 2017 Aug;25(4):503-512. doi: 10.3109/09273948.2016.1142573. Epub 2016 Mar 22.

Abstract

Purpose: To describe the incidence of ocular hypertension (OHT) and secondary glaucoma (SG) in JIA-associated uveitis, identify risk factors for development of these complications, and describe their effect on visual outcomes.

Methods: A retrospective cohort of 108 patients (196 eyes) with JIA-associated uveitis seen over 30 years at an academic practice.

Results: Of examined eyes, 40% had OHT or SG at presentation. These eyes had a nearly three-fold higher incidence of legal blindness during follow-up, compared with eyes without OHT or SG. An additional 41 eyes developed OHT or SG during follow-up. Presenting with anterior uveitis, active inflammation, and using systemic corticosteroids were risk factors for developing OHT, while use of immunosuppressive medication at presentation reduced this risk. Risk factors for developing SG included anterior uveitis and use of systemic corticosteroids.

Conclusions: OHT and SG were common in patients with JIA-associated uveitis. Use of immunosuppressive drugs may decrease the risk of developing OHT.

Keywords: Juvenile idiopathic arthritis; ocular hypertension; secondary glaucoma; uveitis.

MeSH terms

  • Adolescent
  • Arthritis, Juvenile / complications*
  • Arthritis, Juvenile / physiopathology
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Glaucoma / epidemiology
  • Glaucoma / etiology*
  • Glaucoma / physiopathology
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Infant
  • Intraocular Pressure / physiology
  • Male
  • Ocular Hypertension / epidemiology
  • Ocular Hypertension / etiology*
  • Ocular Hypertension / physiopathology
  • Retrospective Studies
  • Risk Factors
  • Tonometry, Ocular
  • Uveitis / complications*
  • Uveitis / physiopathology
  • Visual Acuity / physiology

Substances

  • Glucocorticoids
  • Immunosuppressive Agents