Aqueous Humor Dynamics in Uveitic Eyes

Abstract

To investigate aqueous humor dynamics in uveitic eyes. DESIGN: Cross-sectional study. PARTICIPANTS: Patients with recurrent (‡3 attacks) anterior uveitis (now quiescent) and being treated for glaucoma or ocular hypertension (OHT) (Group 1), previous recurrent anterior uveitis (‡3 attacks) without glaucoma or OHT (Group 2), and normal subjects with no ocular problems and IOP < 21 mm Hg at screening (control group; Group 3). METHODS: Patients had one-off measurements. Group 1 patients who were on antihypertensives were washed out for a 4-week period, prior to their study measurements. Main outcome measures were tonographic outflow facility, aqueous humor flow rate, and uveoscleral outflow. RESULTS: One hundred and one patients were screened between February 2014 and February 2017. Nine patients did not meet the inclusion criteria. Groups 1 and 3 each included 30 patients, and Group 2 included 32 patients. The mean intraocular pressure was higher in Group 1 compared to the others (25 ± 10.2 mm Hg in Group 1 vs 16 ± 2.7 mm Hg in Group 2 vs 16 ± 2.2 mm Hg in Group 3, P < .001). The tonographic outflow facility was lower in Group 1 compared to the others (0.18 ± 0.1 mL/min/mm Hg in Group 1 vs 0.25 ± 0.1 mL/min/mm Hg in Group 2 vs 0.27 ± 0.1 mL/ min/mm Hg in Group 3, P [ .005). However, aqueous humor flow rate was not statistically different (2.47 ± 0.9 mL/min in Group 1 vs 2.13 ± 0.9 mL/min in Group 2 vs 2.25 ± 0.7 mL/min in Group 3, P [ .3). There was also no significant difference in calculated uveoscleral outflow. CONCLUSION: This is the first aqueous humor dynamics study in patients with uveitic glaucoma/OHT and recurrent anterior uveitis compared with agematched controls. We have demonstrated that the elevated intraocular pressure seen in the uveitic glaucoma/OHT eyes (3-6 attacks) was due to reduced tonographic outflow facility. The aqueous humor flow rate was not detectibly different, nor did the calculated uveoscleral outflow demonstrate any discernible difference. However, the exact mechanism remains to be elucidated.

Vitreoretinal Interface Cells Correlate In Vivo With Uveitis Activity and Decrease With Anti-Inflammatory Treatment

“…Further analysis and exploration are undoubtedly necessary for a better understanding of cell interplay in the context of our research. 32 The present study has several limitations. First, the sample size of the patients studied was small, and there was heterogeneity in terms of inflammatory pathologies, which may impact the VRIC measurements.…”

“…Further analysis and exploration are undoubtedly necessary for a better understanding of cell interplay in the context of our research. 32 …”

Structure–Function Relationship and Vision-Related Quality of Life in Glaucoma Secondary to Anterior Uveitis: Comparison with Open Angle Glaucoma

“…A glaucomatous VF was defined by a glaucoma hemifield test result outside of the normal limits and the presence of at least three contiguous points in the pattern deviation plot with p -values < 5%, at least one of which had a p -value < 1%, on two consecutive reliable SAP examinations. The inclusion criteria for UG were a diagnosis of recurrent anterior uveitis with three or more episodes of recurrences, a history of elevated IOP (>21 mmHg) based on Goldmann applanation tonometry (on at least two separate occasions), and a presence of glaucoma [ 24 , 25 ]. We defined OAG as the presence of glaucomatous optic nerve damage and associated visual field defect without ocular disease or conditions that may elevate the IOP.…”

Structure–function Relationship and Vision-related Quality of Life in Glaucoma Secondary to Anterior Uveitis: Comparison with Open Angle Glaucoma

“…The inclusion criteria for UG were a diagnosis of recurrent anterior uveitis with three or more episodes of attacks, a history of elevated IOP (> 21 mmHg) based on Goldmann applanation tonometry (on at least two separate occasions), and glaucoma. 23,24 Glaucoma was de ned as the presence of glaucomatous optic neuropathy (thinning of the neuroretinal rim, peripapillary hemorrhage, or localized pallor) in association with a typical, reproducible VF defect on SAP. A glaucomatous VF was de ned by a glaucoma hemi eld test result outside of the normal limits and the presence of at least three contiguous points in the pattern deviation plot with p-values < 5%, at least one of which had a p-value < 1%, on two consecutive reliable SAP examinations.…”