title: Risk of Hypotony in Juvenile Idiopathic Arthritis-Associated Uveitis.
abstract: To describe risk factors for hypotony in patients with juvenile idiopathic arthritis (JIA)-associated uveitis.
  
  
  
  Retrospective cohort study.
  
  
  
  All patients with JIA-associated uveitis (N = 108; affected eyes = 196) evaluated and followed at the Wilmer Eye Institute from July 1984 through June 2014 were included in this study. Prevalence and incidence of hypotony (intraocular pressure [IOP] <5 mm Hg) and low IOP (5 mm Hg ≤ IOP < 8 mm Hg) and risk factors for developing hypotony were analyzed.
  
  
  
  At presentation, 9.3% of patients (7.1% of affected eyes) had hypotony. During a median follow-up of 5.3 years, the rate of developing hypotony and low IOP were 0.04 per eye-year (/EY; 95% confidence interval [CI]: 0.02/EY, 0.05/EY) and 0.06/EY (95% CI: 0.04/EY, 0.08/EY), respectively. Risk factors for development of hypotony during follow-up appeared to be associated with more severe uveitic disease, such as the presence of panuveitis (adjusted hazard ratio [aHR], 43.1; P = .004), anterior chamber cells or flare ≥ 3+ (aHR, 25.6, P < .001), posterior synechiae (aHR, 5.9, P = .02), and the use of oral corticosteroid (aHR 28.9; P = .003) at the presenting examination. Receiving immunosuppressive drug therapy at the time of presentation was associated with a lower risk of development of hypotony (aHR, 0.02; P = .002).
  
  
  
  Hypotony affects a small but significant proportion of patients with JIA-associated uveitis and is associated with signs of active and severe uveitis. Immunosuppression was associated with significantly lower risk of hypotony, suggesting that aggressive control of the inflammation may reduce risk of hypotony in JIA-associated uveitis.
authors.affiliation: Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Ahmadreza
authors.initials: A
authors.lastname: Moradi
authors.affiliation: Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Inna G
authors.initials: IG
authors.lastname: Stroh
authors.affiliation: Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Ashvini K
authors.initials: AK
authors.lastname: Reddy
authors.affiliation: Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Dana M
authors.initials: DM
authors.lastname: Hornbeak
authors.affiliation: Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Theresa G
authors.initials: TG
authors.lastname: Leung
authors.affiliation: Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Bryn M
authors.initials: BM
authors.lastname: Burkholder
authors.affiliation: Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Epidemiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: jthorne@jhmi.edu.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Thorne
mesh_terms: D000293:Adolescent; D000328:Adult; D001171:Arthritis, Juvenile / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007223:Infant; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D015814:Ocular Hypotension / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014065:Tonometry, Ocular; D014606:Uveitis, Anterior / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014792:Visual Acuity / Q000502:physiology
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents