Secondary glaucoma in patients with uveitis.
OBJECTIVE
To evaluate the prevalence of secondary glaucoma (SG), clinical forms of uveitis more frequently associated with glaucoma, and describe the treatment and complications encountered in a cohort of patients with glaucoma and uveitis during a 10-year period.


METHODS
The hospital records of patients with uveitis referred to the Immunology Service of the Massachusetts Eye and Ear Infirmary for a decade were reviewed for cases of SG.


RESULTS
One hundred and twenty of the 1,254 patients (9.6%) with uveitis developed SG. SG was more frequent in anterior uveitis (67%) but was also associated with posterior uveitis (13%) and pars planitis (4%). Herpetic keratouveitis (22%), Fuchs' iridocyclitis (19%), juvenile rheumatoid arthritis-associated iridocyclitis (16%), syphilis (14%), and sarcoidosis (12%) were the leading types of uveitis associated with SG. Despite aggressive medical and surgical therapy, SG was associated with progressive visual field loss and optic nerve damage in 39 patients (33%).


CONCLUSIONS
SG is an underappreciated, vision-threatening complication in patients with uveitis. Increased vigilance for emergence of this complicating problem during the care of patients with uveitis is warranted, and medical and surgical treatment for reducing IOP should be especially aggressive in these patients. We hypothesize that earlier, more aggressive treatment of uveitis will reduce the presence of glaucoma as an additional vision-robbing complication of uveitis.
Merayo-Lloves
J
J
Ocular Immunology and Uveitis Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA.
Power
W J
WJ
Rodriguez
A
A
Pedroza-Seres
M
M
Foster
C S
CS
D000293:Adolescent; D018663:Adrenergic Agents / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005901:Glaucoma / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000209:etiology; D015995:Prevalence; D014605:Uveitis / Q000145:classification / Q000150:complications*; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity; D014794:Visual Fields
D018663:Adrenergic Agents; D002257:Carbonic Anhydrase Inhibitors