Ocular Hypotony in Patients With Juvenile Idiopathic Arthritis-Associated Uveitis

Am J Ophthalmol. 2017 Jan;173:45-55. doi: 10.1016/j.ajo.2016.09.018. Epub 2016 Sep 21.

Abstract

Purpose: To analyze occurrence, risk factors, and course of ocular hypotony (OH) in juvenile idiopathic arthritis-associated uveitis (JIAU).

Design: Cohort study.

Methods: Epidemiologic and ophthalmologic data at baseline and during follow-up of JIAU patients with and without ocular hypotony were evaluated.

Results: OH developed in 57 of the 365 JIAU patients during the follow-up (mean 4.5 ± 3.5 years). In 40 patients with follow-up ≥12 months, OH was unrelated to previous ocular surgery: risk factors at baseline (univariate logistic regression analysis) included longer total duration of uveitis (odds ratio [OR] 1.13, P < .001), bilateral uveitis (OR 3.51, P = .009), low visual acuity (OR 5.1, P = .001), high laser-flare (LF) values (OR 1.74, P = .01), and presence of posterior synechiae (OR 3.28, P = .004). Increased anterior chamber (AC) cell and LF values were observed within 3 months prior to onset of transient (≤3 months; 37.5%) or persistent OH (>3 months; 62.5%). AC cell and LF values decreased within 3 months after onset of transient OH, while LF levels remained elevated ≥12 months in persistent OH. Optic disc edema and epiretinal membrane formation was found more frequently after OH onset.

Conclusions: OH was observed in 15.6% of JIAU patients. Longer total uveitis duration, bilateral uveitis, low visual acuity, high AC flare and LF grades, and presence of posterior synechiae at baseline were risk factors for subsequent OH. Burden of OH might be improved with immunosuppression.

MeSH terms

  • Arthritis, Juvenile / complications*
  • Arthritis, Juvenile / diagnosis
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Germany / epidemiology
  • Humans
  • Incidence
  • Intraocular Pressure*
  • Male
  • Ocular Hypotension / epidemiology
  • Ocular Hypotension / etiology*
  • Ocular Hypotension / physiopathology
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Uveitis, Anterior / complications*
  • Uveitis, Anterior / diagnosis
  • Uveitis, Anterior / physiopathology
  • Visual Acuity