Laser flare photometry and complications of chronic uveitis in children

Davis, Janet L.; Dacanay, Leonardo M; Holland, Gary N.; Berrocal, Audina M.; Giese, Michael J.; Feuer, William J.

doi:10.1016/s0002-9394(03)00315-5

Cited by 68 publications

(52 citation statements)

References 7 publications

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“…In this connection, juvenile idiopathic arthritis (JIA) was more frequent in the TRAB group (5 eyes vs 1 eye in the DS group, P ¼ 0.089), and it has been reported that JIA-associated uveitis may create a large blood-aqueous barrier breakdown, with a positive correlation between increased laser flare photometry values and complications at baseline in Eye children with this type of uveitis. 19 Here, this feature might have increased the rate of failure in our TRAB group. However, although intraocular inflammation at postoperative day 7 was more marked in the TRAB than the DS group (as reported by Chiou in non-uveitic glaucoma 20 ) in this study, final visual acuity and the complications rate were not different in the two groups.…”

Section: Discussionmentioning

confidence: 88%

Deep sclerectomy and trabeculectomy in uveitic glaucoma

Dupas

Fardeau

Cassoux

et al. 2009

Eye

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Purpose To compare the results of deep sclerectomy (DS) and trabeculectomy (TRAB) in the management of uveitic glaucoma. Methods A retrospective chart review was carried out of 41 eyes (38 patients) operated on for uncontrolled uveitic glaucoma, 20 by DS with an implant and 21 by TRAB, with antiproliferative agents in both cases. Main outcome criteria were intraocular pressure (IOP), flare values, complications, and need for postoperative adjustments or re-operation. Results Mean follow-up lasted 21.1±11.3 months in the TRAB group and 18.9 ± 10.7 months in the DS group (P ¼ 0.184). Mean IOP did not differ significantly in the two groups on the day before surgery, at postoperative days 1 and 7, or at months 1, 6, and 12. At postoperative month 12, IOP values in the TRAB and DS groups were 12.4±4.3 and 11.7±3.3 mm Hg (P ¼ 0.688), respectively. The cumulative probability of success at 12 months was 89% for TRAB and 88% for DS (P ¼ 0.306). After DS, more postoperative adjustments were necessary to lower IOP than after TRAB (85 vs 9.5%, Po0.001), but 7 days after surgery, intraocular inflammation was higher after TRAB (245.8 vs 38.5 ph/ms, Po0.001). Conclusions DS and TRAB afforded equivalent IOP control in uveitic glaucoma. TRAB involved deeper invasion of the eye and resulted in more inflammation during the week after surgery, but successful DS required closer postoperative monitoring and more postoperative adjustments.

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Section: Discussionmentioning

confidence: 88%

Deep sclerectomy and trabeculectomy in uveitic glaucoma

Dupas

Fardeau

Cassoux

et al. 2009

Eye

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“…The resulting light scattering and reflection can be seen as Tyndall effect at the slit-lamp examination and can be quantified with LF photometry. Previously, increased flare values were detected in uveitis patients (Davis et al 2003). Although in published studies the LF levels mostly correlated with the presence of cells in the AC and disease activity, flare was also determined without overt inflammatory activity, but in the presence of certain uveitis complications, e.g.…”

Section: Discussionmentioning

confidence: 95%

“…Although in published studies the LF levels mostly correlated with the presence of cells in the AC and disease activity, flare was also determined without overt inflammatory activity, but in the presence of certain uveitis complications, e.g. posterior synechiae and cystoid macular oedema (Davis et al 2003;Holland 2007). Acute inflammation seems to influence the BAB dramatically, leading to very high LF values; however, after adequate treatment, a quick restoration of BAB may occur.…”

Section: Discussionmentioning

confidence: 99%

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Elevated laser flare values correlate with complicated course of anterior uveitis in patients with juvenile idiopathic arthritis

Tappeiner

Heinz

Roesel

et al. 2011

Acta Ophthalmologica

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. Purpose: To evaluate the prognostic value of anterior chamber (AC) laser flare (LF) in uveitis associated with juvenile idiopathic arthritis (JIA). Methods: Monocentre, retrospective study of 150 JIA children (girls n = 107, 71.3%) with unilateral or bilateral chronic anterior uveitis (statistical analysis of one eye per patient). LF values (KOWA FM‐500), visual acuity, intraocular pressure, glaucoma treatment and uveitis complications were investigated longitudinally. Results: Patients were followed up for a mean of 8.7 months (range 1–36). High LF values correlated with poor visual acuity (p < 0.0001). Patients with low LF values (LF ≤ 20 photon units per millisecond) less often required glaucoma medication (p = 0.0005) or surgery (p = 0.01) and showed a lower prevalence of cataract, band keratopathy, posterior synechiae, epiretinal membrane, optic disc oedema and glaucoma/ocular hypertension (p < 0.05, each). Baseline LF > 20 photon units per millisecond was a better prognosticator for the development of subsequent complications than baseline AC cells (p = 0.04). Conclusions: High LF values in patients with JIA uveitis are associated with poor vision and a higher prevalence of uveitis complications.

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“…Presence of anterior chamber flare as measured by laser flare photometry has been reported previously to be associated with the presence of any ocular complication and with poorer visual acuity at the initial examination in a cohort of 59 children with chronic uveitis, 29% of whom were diagnosed with JIA. 20 The presence of posterior synechiae at presentation also has been reported to be a risk factor for the development of ocular complications and loss of visual acuity over follow-up time and likely is a surrogate for disease severity at presentation. 5,14 In our cohort, presence of posterior synechiae was associated with 20/200 or worse vision at presentation after controlling for other variables.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Ocular Complications and Poor Visual Acuity at Presentation Among Patients With Uveitis Associated With Juvenile Idiopathic Arthritis

Woreta

Thorne

Jabs

et al. 2007

American Journal of Ophthalmology

159

131

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Purpose-To describe the frequencies of and risk factors for ocular complications and poor visual acuity at presentation in a cohort of patients with juvenile idiopathic arthritis (JIA)-associated uveitis.Design-Cross-sectional study.Setting Single-center, academic practice. Procedures Data on patients diagnosed with JIA-associated uveitis were entered retrospectively into a database and analyzed. Study populationOutcome measures Visual acuity of 20/50 or worse or 20/200 or worse, and presence of ocular complications (including cataract, posterior synechiae, band keratopathy, elevated intraocular pressure, hypotony, macular edema, and epiretinal membrane) at presentation.Results-At presentation, ocular complications were seen in 67% of eyes affected by JIAassociated uveitis. Presence of ≥ 1+ anterior chamber flare, a positive antinuclear antibody, and a shorter duration between the diagnosis of arthritis and uveitis were significantly associated with the presence of ocular complication. The frequencies of 20/50 or worse and of 20/200 or worse visual acuities at presentation in affected eyes were 36% and 24%, respectively. The presence of ≥ 1+ anterior chamber flare and a history of intraocular surgery prior to presentation were significantly associated with 20/50 or worse and 20/200 or worse vision. Presence of posterior synechiae also was associated with 20/200 or worse vision at presentation. The main causes of poor vision at presentation for affected eyes and better-seeing eyes were cataract, band keratopathy within the visual axis, and glaucoma.Conclusions-Ocular complications and poor vision at presentation were common in our patients with JIA-related uveitis.

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Laser flare photometry and complications of chronic uveitis in children

Cited by 68 publications

References 7 publications

Deep sclerectomy and trabeculectomy in uveitic glaucoma

Deep sclerectomy and trabeculectomy in uveitic glaucoma

Elevated laser flare values correlate with complicated course of anterior uveitis in patients with juvenile idiopathic arthritis

Risk Factors for Ocular Complications and Poor Visual Acuity at Presentation Among Patients With Uveitis Associated With Juvenile Idiopathic Arthritis

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