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The risk of uveitis due to prostaglandin analogs in pediatric glaucoma

Nicholas R Bello1, Kara C LaMattina2, Jade M Minor1

  • 1Pediatric Ophthalmology and Ocular Genetics, Wills Eye Hospital, Philadelphia, Pennsylvania.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|May 13, 2022
PubMed

Insights

Prostaglandin analogs (PGAs) are unlikely to induce uveitis in pediatric glaucoma patients. Recurrence in those with prior uveitis history may be linked to reduced steroid use, not PGAs.

Area of Science:

  • Ophthalmology
  • Pediatric Glaucoma Management
  • Uveitis Research

Background:

  • Pediatric glaucoma requires long-term management, often involving medications like prostaglandin analogs (PGAs).
  • Uveitis is a potential concern in glaucoma patients, particularly in pediatric populations.
  • The safety profile of PGAs regarding uveitis induction or recurrence in children needs further elucidation.

Purpose of the Study:

  • To investigate the incidence of new or recurrent uveitis in children treated with prostaglandin analogs (PGAs) for glaucoma.
  • To assess the safety of PGAs in pediatric glaucoma patients, including those with a history of uveitis.

Main Methods:

  • Retrospective cohort study of 103 children (<18 years) treated with PGAs for glaucoma across two centers.
  • Analysis of medical records for new or recurrent uveitis within the first year of PGA therapy.
  • Inclusion of patients with all glaucoma types and prior uveitis history; exclusion of those already on PGAs.

Main Results:

  • Out of 103 children, 98 (142 eyes) tolerated PGAs without uveitis.
  • Five patients with a history of uveitis experienced recurrence, potentially linked to decreased topical steroid or immunosuppressive medication use.
  • Total PGA exposure was 1,352 child-months.

Conclusions:

  • Prostaglandin analogs (PGAs) appear unlikely to induce uveitis in pediatric glaucoma patients.
  • PGAs may also be safe in children with a history of uveitis, though recurrence warrants further investigation.
  • The study could not definitively assess if PGAs increase recurrence likelihood or complicate steroid tapering.
Abstract

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