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Predictive Factors for Ocular Hypertension and Glaucoma Secondary to Uveitis: Insights from a Tertiary Referral
Mahmut Asfuroğlu1, Cenk Zeki Fikret1, Meltem Kılıç1
1Department of Ophthalmology, Ankara Bilkent City Hospital, Ankara, Türkiye.
Purpose:
The aim of this study was to investigate the predictive factors for the development of uveitic glaucoma (UG) and ocular hypertension secondary to uveitis (OHT-SU).
Method:
The medical records of 1,160 patients with uveitis at a tertiary referral hospital in Ankara were analyzed. A total of 97 eyes of 81 patients with UG/OHT-SU were identified. In addition to demographic and etiological data, patients were analysed for the presence of synechiae, peak intraocular pressure (IOP) and peak anterior chamber reaction, need for glaucoma and cataract surgery during follow-up.
Results:
The most prominent etiologies associated with UG/OHT-SU were viral uveitis, followed by Fuchs' uveitis, Behçet's disease and pars planitis. Elevated peak IOP measurements were found to be correlated with the development of glaucoma in patients with uveitis (p < 0.001). The findings indicated that an increased peak anterior chamber reaction was a risk factor for the necessity of glaucoma surgery (OR = 4.04; 95% CI = 2.43-6.71; p < 0.001). The formation of synechiae was associated with increased peak anterior chamber reactions (p = 0.004), resulting in a higher incidence of surgical intervention for glaucoma (OR = 5.51; 95% CI = 2.00-15.20; p = 0.001).
Conclusion:
UG/OHT-SU is a specific condition that affects a notable proportion of uveitis patients in Turkey, requiring a multidisciplinary approach. In patients with uveitis, elevated peak IOP, pronounced anterior chamber reaction and synechia formation are crucial factors in the progression to glaucoma and the escalating necessity for surgical intervention. Early and effective control of inflammation is needed to prevent progression to refractory glaucoma and vision loss in these patients.
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