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Risk Factors for Elevated Intraocular Pressure in Uveitis

Herbert, Helen M. MSc, MRCOphth; Viswanathan, Ananth FRCOphth; Jackson, Heather FRCOphth; Lightman, Susan L. FRCP, FRCOphth

Original Article

Purpose: To determine the prevalence of raised intraocular pressure (IOP) in patients with uveitis and to identify risk factors for raised IOP in patients with uveitis.

Patients and Methods: Consecutive case notes of 257 patients (402 eyes) attending a specialist uveitis clinic during a three-month period were reviewed. Patients with raised IOP were identified and further evaluated. Risk factors for raised IOP were determined.

Results: The prevalence of raised IOP in the study eyes was 41.8%. The prevalence of raised IOP requiring treatment was 29.8%. Raised IOP was found in 26.0% of eyes with acute uveitis and 46.1% of eyes with chronic uveitis. This difference was significant (P = 0.002). Similarly the prevalence of raised IOP requiring treatment in acute and chronic uveitis was 15.1% and 33.8%, respectively. This difference was also significant (P = 0.002). Active inflammation was significantly associated with raised IOP (P = 0.031). Steroid usage, increasing age, and number of years since diagnosis were significantly correlated with raised IOP (P = 0.008, P = 0.022, and P = 0.006, respectively); 9.6% of the study eyes developed glaucoma. The majority of these eyes (69.7%) were treated medically. The remainder (30.3%) required both medical and surgical management.

Conclusion: Raised IOP is significantly more common in patients with chronic intraocular inflammation than those with acute uveitis. Risk factors for elevated IOP that should enable closer monitoring of ‘at-risk’ eyes have been identified.

From the Department of Clinical Ophthalmology, Institute of Ophthalmology, Moorfields Eye Hospital, City Road, London, UK.

Received for publication March 18, 2003; accepted September 17, 2003.

Originally presented by H.M. Carson, H. Jackson, and S.L. Lightman as Raised Intraocular Pressure in Patients with Uveitis to the Association for Research in Vision and Ophthalmology, Fort Lauderdale, Florida, May 1998. (Abstract No. #2830).

Reprints: Susan L. Lightman, Department of Clinical Ophthalmology, Institute of Ophthalmology, Moorfields Eye Hospital, City Road, London EC1V 2PD (e-mail: s.lightman@ucl.ac.uk).

© 2004 Lippincott Williams & Wilkins, Inc.