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Rabia Aman, Asima Bajwa, patrie james, Wenjun Xin, Ashvini Reddy; Ocular Hypotension and Hypertension as Determinants of Outcomes in Uveitis. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5786.
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© ARVO (1962-2015); The Authors (2016-present)
To report outcomes associated with ocular hypotony and hypertension in a cohort of uveitis patients managed over a 30 year period.
Retrospective review of 461 patients (481 eyes) with uveitis managed at the University of Virginia from 1984 - 2014. Ocular hypotony and hypertension were defined as baseline intraocular pressure (IOP) less than 8 mmHg or greater than 21 mmHg, respectively. Primary outcome measures were final visual acuity and final IOP. Demographics, clinical findings, and management were analyzed for statistical significance.
Twenty-six eyes of 25 patients had baseline ocular hypotony, which was not significantly associated with age (P=0.963), race (P =1.00), gender (P=0.537), or anatomical classification of uveitis (P=0.826). Of these patients, 18 (72%), 4 (16%), and 2 (8%) were treated with local steroids, combination local and systemic steroids, and antimetabolites, respectively. One patient received no treatment. Final visual acuity of eyes with ocular hypotension was 20/150, which was not significantly different from normotensive eyes (P=0.0748). Final IOP of eyes with baseline hypotony was 14.9 mmHg, which was not significantly different than that of normotensive uveitic eyes (P=0.8829).<br /> <br /> 110 eyes of 85 patients had baseline ocular hypertension, which was associated with anterior uveitis (76%, P=0.072), but not age (P=0.9407), race (P =0.072) or gender (P=0.628?). 70 ocular hypertension patients (82%) had been treated with topical steroid during study (p=0.093). 27 patients (32%) were managed with glaucoma medications , 3 patients (4%) glaucoma surgery , and 15 patients (18%) ,combination medical and surgical glaucoma management. Final visual acuity of eyes with baseline ocular hypertension was Snellen 20/90, which was not significantly different than that of 356 normotensive uveitic eyes (P=0.2237). Final IOP of eyes with baseline hypertension was 15.0 mmHg, which was not significantly different than that of eyes with normal baseline intraocular pressure (P=0.9868).
Neither baseline hypotony nor hypertension in uveitis was associated with poorer visual acuity and lower final IOP compared to patients with normal baseline IOP. Uveitic patients with abnormal IOP can expect final vision and pressure similar to uveitic patients who are normotensive at baseline.
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