Prevalence and clinical characteristics of uveitic glaucoma: multicentric study in Bogotá, Colombia

Abstract

Objectives To describe the clinical features of patients diagnosed with uveitic glaucoma (UG) and ocular hypertension secondary to uveitis (OHT-SU). Methods A multicentric cross-sectional study using medical records of patients with uveitis between 2013 and 2021. Uveitis and glaucoma specialists examined all patients. Variables were analyzed using the chi-square or Fisher’s exact test for categorical variables. Additionally, t test, Mann–Whitney, and Kruskal–Wallis variance analysis were used for continuous variables. Finally, a Kaplan–Meier survival analysis for UG and OHT-SU development over time was done. Results Of the 660 clinical records reviewed of patients with uveitis, 191 (28.9%) had OHT-SU in at least one visit, and 108 (16.4%) of them developed UG. In all ages, females were more affected than males. Anterior uveitis was the main anatomic localisation, and non-granulomatous, recurrent, and inactive uveitis were the most frequent clinical features. The mean final visual acuity was 0.3 (0.0–1.0) LogMAR. Also, 95.8% of the patients had additional sequelae related to uveitis regardless of UG and OHT-SU. Interestingly, males had earlier affection, with statistical significance in OHT for adults (P = 0.036) and UG for children (P = 0.04). Of all patients, 81.1% received topical hypotensive treatment and 29.8% required a surgical procedure. Conclusions UG and OHT-SU are common complications of uveitis in the Colombian population. These sight-threatening conditions were more common and appeared sooner in men at any age. Our results suggest that earlier and more aggressive treatment with topical hypotensive agents could positively influence the visual outcomes and the requirement of surgical procedures.

Quantitative changes in the corneal endothelium and central corneal thickness during anterior chamber inflammation: A systematic review and meta-analysis

“…Another leading cause of endothelial damage in patients with ACI is the long-term use of corticosteroids (topical or systemic) [49,50], which can lead to common complications such as cataracts and glaucoma [51]. The adverse effects of elevated IOP on the endothelium are well established, with both open-angle and acute angle-closure glaucoma reporting endothelial damage [43,46,52,53].…”

Update on Diagnosis and Treatment of Uveitic Glaucoma

“…According to several studies, almost 30% of patients with UG will need surgical treatment [ 8 , 59 , 60 ]. This percentage may be significantly higher in children [ 8 ].…”

“…Uveitis patients may have a wide variation in their IOP and there is always a possibility of ocular hypertension alternating with ocular hypotony, with devastating consequences for the eye. While reviewing the literature of more than two decades, it is generally accepted that either trabeculectomy [ 59 ] or valve [ 60 ] implantation are safe and most of the times successful procedures in the treatment of UG. However, most of studies evaluating surgical techniques in UG are retrospective in their design with a small number of participants; furthermore, they present data in various different ways, and many of them have a limited follow-up period.…”