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Dan Liu, Helen Han, Arkadiy Yadgarov, David S Chu, Albert S Khouri; Fluctuations of Intraocular Pressure in Uveitic Glaucoma Before and After Surgical Intervention. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6445.
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© ARVO (1962-2015); The Authors (2016-present)
Fluctuations in intraocular pressure (IOP) may be associated with glaucomatous visual field loss and progression. In uveitis, abnormalities of IOP can progress to pathologically elevated IOP in uveitic glaucoma (UG). The purpose of this clinical retrospective, observational study is to evaluate IOP fluctuations in patients with UG before and after surgical intervention with glaucoma drainage devices.
Data on IOP and glaucoma medications were collected from 5 visits immediately preceding surgery and up to 24 months postoperatively in patients with UG. Inclusion criteria included diagnosis of UG, glaucoma drainage surgery, availability of data preoperatively, and follow-up time up to 24 months. Eyes with glaucoma other than UG or less than 3 months follow-up were excluded. Outcomes measured include IOP mean, number of medications, and IOP fluctuations as assessed by 4 parameters including IOP standard deviation (SD), IOP range, IOP deviation from the mean (mean deviation), and maximum IOP. Statistical analysis was performed using paired t-test with significance level of α=0.05.
489 data points from 55 eyes (46 patients) were included. Etiologies of uveitis in the study included idiopathic uveitis (37 eyes, 67.3%), sarcoidosis (7 eyes, 12.7%), rheumatoid arthritis (5 eyes, 9.0%), and HLA-B27 associated seronegative spondyloarthropathies (3 eyes, 5.4%). Other causes of uveitis (3 eyes, 5.4%) included post-procedural uveitis, herpetic anterior uveitis, and Vogt-Koyanagi-Harada syndrome. At the time of surgery, 29 eyes (52.7%) were phakic, 24 eyes (43.6%) were pseudophakic, and 2 eyes (3.6%) were aphakic (Table 1). Mean follow-up time preceding and following surgery were 4.5±5.8 months and 23.1±20.3 months, respectively. The mean IOP in patients with UG preceding and following surgical intervention was 29.4±10.5mmHg and 16.4±6.5mmHg, respectively (P<0.05) (Table 2). The mean number of medications in patients with UG before and after surgical intervention was 3.4±1.3 and 1.4±1.2, respectively (P<0.05). All four parameters of IOP fluctuations before and after surgical intervention were significantly decreased postoperatively (Table 2).
Surgical intervention with glaucoma drainage devices in patients with UG can significantly lower IOP fluctuations, mean IOP, and maximum IOP postoperatively.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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