Ocular hypertension and secondary glaucoma in children with uveitis.
OBJECTIVE
To identify the risk factors for ocular hypertension and secondary glaucoma in children with uveitis.


METHODS
Retrospective observational case series of 147 patient records.


METHODS
Two hundred fifty-six eyes of 147 children with uveitis diagnosed before the age of 16 years.


METHODS
Data were obtained from the medical records of children with uveitis evaluated at our institute from 1990 through 2004.


METHODS
Localization and course of uveitis (acute or chronic), underlying systemic disease, onset of ocular hypertension, onset of secondary glaucoma, treatment with steroids, antinuclear antibodies (ANAs), lens extractions, number of blind eyes at onset and during follow-up, and the duration of follow-up.


RESULTS
Elevated intraocular pressure developed in 35% of children with pediatric uveitis regardless of the form or type of uveitis during a follow-up of 5 years. Secondary glaucoma, however, developed more frequently in juvenile idiopathic arthritis-associated uveitis (38%) compared with other forms of uveitis (11%) and more frequently in children with uveitis who were ANA positive (42%) than in those who were ANA negative (6%). Elevated intraocular pressure occurred in two thirds of all children within the first 2 years after the diagnosis of uveitis. Except for patients with juvenile idiopathic arthritis-associated uveitis, periocular steroid injections represented an additional risk factor for secondary glaucoma, but this risk was limited to the early phase of the disease process.


CONCLUSIONS
In children with uveitis in this series, juvenile idiopathic arthritis-associated uveitis and ANA-positive uveitis without evidence of arthritis are the most important risk factors for developing secondary glaucoma.
Sijssens
Karen M
KM
FC Donders Institute of Ophthalmology, University Medical Center, Utrecht, The Netherlands. k.sijssens@oogh.azu.nl
Rothova
Aniki
A
Berendschot
Tos T J M
TT
de Boer
Joke H
JH
D000208:Acute Disease; D017668:Age of Onset; D002648:Child; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000209:etiology*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D009798:Ocular Hypertension / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D014065:Tonometry, Ocular; D014605:Uveitis / Q000145:classification / Q000150:complications*