title: Ocular hypotension and hypotony in multibacillary leprosy patients; at diagnosis, during and after completion of multidrug therapy.
abstract: The prevalence and incidence of ocular hypotony (IOP < 7 mm Hg) and factors associated with them were determined in a Leprosy Referral Centre at Tamilnadu, India. Applanation intraocular pressures were measured every six months in a cohort of newly diagnosed multibacillary (MB) leprosy patients who were followed-up during the two year period of multidrug therapy (MDT) and for five years thereafter. Transient hypotony was present in two patients at the time of diagnosis, in 3 patients during MDT and in 9 patients after MDT with a cumulative prevalence of 4.65%. Transient ocular hypotension was present in 24 patients (8%) at disease diagnosis. 25 patients developed hypotension during MDT that was associated with trichiasis (HR 8.83 95% CI 2.06, 37.78 p = 0.003) and flare or/and cells (HR 4.60 95% CI 1.08, 19.64 p = 0.039). 29 patients developed ocular hypotension after MDT that was associated with punctate keratitis and uveal involvement. In general, MB leprosy patients with hypotension had a mean IOP of 12.60 mm Hg which differed significantly (p < 0.0001) from the mean IOP of 14.9 mm Hg in those who did not have hypotension. Transient hypotension and hypotony in MB leprosy patients are associated with signs of intraocular inflammation.
authors: Department of Ophthalmology, University of Pennsylvania, 3535 Market Street, Ste 700, Philadelphia, PA 19104, USA. ebdaniel@mail.med.upenn.edu
authors: E
authors: E
authors: Daniel
authors: P S S
authors: PS
authors: Rao
authors: T J
authors: TJ
authors: Ffytche
authors: P
authors: P
authors: Courtright
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007917:Leprostatic Agents / Q000627:therapeutic use*; D056006:Leprosy, Multibacillary / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D015814:Ocular Hypotension / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
chemical_list: D007917:Leprostatic Agents