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Incidence and Risk Factors for Developing Glaucoma Among Patients with Uveitis in a University-based Tertiary
Khalid Al Rubaie1, Huda Al Dhahri1, Abdullah Al Fawaz1
1a Department of Ophthalmology , College of Medicine, King Saud University , Riyadh , Saudi Arabia .
Purpose:
To investigate the incidence and risk factors of secondary glaucoma among uveitis patients.
Methods:
Retrospective review of medical records of 642 patients (1220 eyes).
Results:
Glaucoma was diagnosed in 169 (13.9%) eyes and was most common in eyes with anterior uveitis (19.1%) (p < 0.001). HLA-B27-positive anterior uveitis (27.6%), Fuchs' uveitis (23.3%), juvenile idiopathic arthritis (23.1%), herpetic uveitis (20.3%), and Vogt-Koyanagi-Harada disease (16.3%) were the leading clinical entities associated with glaucoma (p < 0.001). Significant risk factors at presentation included worse visual acuity, elevated intraocular pressure, keratic precipitates, granulomatous inflammation, anterior chamber reaction≥ 2+, posterior synechiae, and cataract. Female gender and iris nodules significantly predicted the need for glaucoma surgery. Visual outcome was worse in eyes with glaucoma than in eyes without glaucoma.
Conclusions:
Incidence of glaucoma differed depending on anatomic and etiologic diagnoses of uveitis. There is a significant association between severity of inflammation at presentation and development of glaucoma.