June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Aqueous humor dynamics in uveitis: a comparative study in hypertensive uveitis
Author Affiliations & Notes
  • Pouya Alaghband
    Ophthalmology, St Thomas Hospital, London, United Kingdom
    Diabetes and Nutritional Sciences, King's College London, London, United Kingdom
  • Alex Baneke
    Ophthalmology, St Thomas Hospital, London, United Kingdom
  • Elizabeth Galvis
    Ophthalmology, St Thomas Hospital, London, United Kingdom
  • Micahel Madekurozwa
    Bioengineering, Imperial College London, London, United Kingdom
  • Brian Chu
    Bioengineering, Imperial College London, London, United Kingdom
    Bioengineering, Oxford University, Oxford, United Kingdom
  • Darryl Overby
    Bioengineering, Imperial College London, London, United Kingdom
  • Miles Stanford
    Ophthalmology, St Thomas Hospital, London, United Kingdom
    Diabetes and Nutritional Sciences, King's College London, London, United Kingdom
  • K Sheng Lim
    Ophthalmology, St Thomas Hospital, London, United Kingdom
    Diabetes and Nutritional Sciences, King's College London, London, United Kingdom
  • Footnotes
    Commercial Relationships   Pouya Alaghband, None; Alex Baneke, None; Elizabeth Galvis, None; Micahel Madekurozwa, None; Brian Chu, None; Darryl Overby, None; Miles Stanford, None; K Sheng Lim, None
  • Footnotes
    Support  The Royal College of Ophthalmologists, London, United Kingdom
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3477. doi:
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      Pouya Alaghband, Alex Baneke, Elizabeth Galvis, Micahel Madekurozwa, Brian Chu, Darryl Overby, Miles Stanford, K Sheng Lim; Aqueous humor dynamics in uveitis: a comparative study in hypertensive uveitis. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3477.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Comparison of the aqueous humor parameters in patients with recurrent idiopathic anterior uveitis with healthy controls.

Methods : Patients with a history of idiopathic recurrent anterior uveitis (≥3 attacks) with or without raised IOP (> 21 mmHg) were enrolled. All patients were quiescent at the time of enrolment. Normal healthy subjects with no ocular problems and IOP < 21mmHg at screening formed the control group. Exclusion criteria were patients with active intraocular inflammation, patients with other forms of secondary glaucoma, patients who previously had intraocular or laser surgery, those on systemic medication which can affect aqueous humor production and uveoscleral outflow and those with a history of allergy to fluorescein. Before study measurements, subjects were washed out of all hypotensive medications in the study eye for 4 weeks.
Aqueous humor dynamics were assessed by digital Shiøtz tonography, fluorophotometry, and pneumatonometry. Uveoscleral outflow was calculated using Goldmann’s equation with an assumed episcleral venous pressure of 10 mmHg.

Results : Thirty-two healthy volunteers, 32 patients with uveitis with normal IOP and 26 cases with hypertensive uveitis were recruited. The participants’ characteristics are shown in Table 1.

The mean tonographic outflow facility (C) in hypertensive uveitis cases was 0.20±0.14 µl/min/mmHg. This was significantly lower than controls (0.23±0.09 µl/min/mmHg, p=0.03) as well normotensives with uveitis (0.26±0.13 µl/min/mmHg, p=0.05). However, the aqueous flow rate (Ft) was similar across all groups (2.2± 0.72 µl/min, 2.1± 0.89 µl/min, and 2.5±0.88 µl/min). Additionally, the uveoscleral outflow (Fu) was comparable between all groups (Table 2).

Conclusions : 1. Aqueous humor production is not significantly affected by several attacks (≥3) of uveitis in eyes with or without raised IOP.
2. The cause of raised IOP in hypertensive uveitis is related to the reduction in trabecular outflow.
3. As none of the eyes were actively inflamed at the time of the study, cells and debris obstruction of the trabecular meshwork is unlikely.
4. One can assume that repeated episodes of uveitis and perhaps previous exposure to topical corticosteroids lead to permanent structural alteration of the trabecular meshwork in those eyes with hypertensive uveitis.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

Tabel 1. Participants characteristics

Tabel 1. Participants characteristics

 

Table 2. Aqueous humor dynamics parameters

Table 2. Aqueous humor dynamics parameters

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