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Clinical Evaluation of Uveitis-Associated Secondary Glaucoma
A DGReview of :"A Clinical Evaluation of Uveitis-associated Secondary Glaucoma."
Japanese Journal of Ophthalmology
12/11/2002
By Mark Moran
Evaluation and management of intraocular pressure are critical in the treatment of patients with uveitis because of its possible association with secondary glaucoma.
Japanese researchers found an incidence of secondary glaucoma of 18.3 percent among 1,604 eyes with uveitis, though the glaucoma differed depending upon the clinical entity of uveitis.
Subjects in the study were 1,099 patients with uveitis (1,604 eyes) treated at the Miyata Eye Hospital, Miyakonojo, Miyazaki, Japan, between October 1974 and January 2000. Clinical data and data on intraocular pressure (IOP) were analyzed retrospectively. Secondary glaucoma was diagnosed in cases where IOP was higher than 21 mm Hg at two consecutive visits and medication was required.
The type of uveitis differed among the patients. Clinical uveitis was found in 100 percent, followed by sarcoidosis in 34.1 percent, herpetic anterior uveitis in 30.4 percent, Behcet's disease in 20.8 percent, human leukocyte antigen-B27-related acute anterior uveitis in 20.0 percent, Vogt-Koyanagi-Harada's disease in 16.4 percent, and human T-lymphotropic virus type 1 uveitis in 16.2 percent.
Posner Schlossman syndrome glaucoma was found in 293 (18.3 percent) of the eyes. Among these, the majority (72 percent) had active anterior uveitis at the time of high IOP.
Peripheral anterior synechia wider than 180 degrees of the trabecular meshwork was found in only 7.5 percent of the secondary glaucoma eyes. Only 8.9 percent of the secondary glaucoma eyes had steroid-induced glaucoma.
Trabeculectomy with anti-metabolites was the primary form of surgical therapy performed. Of 38 eyes undergoing surgery, 34 had post-surgical IOP under 20 mm Hg. Despite the medical and surgical therapy, visual field defect was found in 39 percent of the secondary glaucoma eyes.
Jpn J Ophthalmol 2002; Sep-Oct;46(5):556-62.
"A Clinical Evaluation of Uveitis-associated Secondary Glaucoma."
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