April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
Incidence and Risk factors for Hypotony in Uveitis
Author Affiliations & Notes
  • Ebenezer Daniel
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
  • Maxwell Pistilli
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
  • Robert B. Nussenblatt
    National Eye Inst/NIH, Bethesda, Maryland
  • James T. Rosenbaum
    Casey Eye Institute-OHSU, Portland, Oregon
  • Eric B. Suhler
    Uveitis Clinic/Portland VAMC,
    Casey Eye Institute-OHSU, Portland, Oregon
  • Jennifer E. Thorne
    Ophthalmology, Johns Hopkins Wilmer Eye Inst, Baltimore, Maryland
  • C Stephen Foster
    Ocular Immunology and Uveitis Foundation, Cambridge, Massachusetts
  • Douglas A. Jabs
    Ophthalmology, Mount Sinai School of Medicine, New York, New York
  • Grace A. Levy-Clarke
    St Lukes Cataract and Laser Institute, St Petersburg, Florida
  • John H. Kempen
    Ophthalmology/Biostatistics&Epidemiology, Scheie Eye Inst/Univ of Penn, Philadelphia, Pennsylvania
  • Footnotes
    Commercial Relationships  Ebenezer Daniel, None; Maxwell Pistilli, None; Robert B. Nussenblatt, None; James T. Rosenbaum, None; Eric B. Suhler, None; Jennifer E. Thorne, None; C Stephen Foster, None; Douglas A. Jabs, None; Grace A. Levy-Clarke, None; John H. Kempen, None
  • Footnotes
    Support  Funded primarily by NIH Grant EY-014943, additional from Research to Prevent Blindness and the Mackall Foundation.
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 4308. doi:
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      Ebenezer Daniel, Maxwell Pistilli, Robert B. Nussenblatt, James T. Rosenbaum, Eric B. Suhler, Jennifer E. Thorne, C Stephen Foster, Douglas A. Jabs, Grace A. Levy-Clarke, John H. Kempen; Incidence and Risk factors for Hypotony in Uveitis. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4308.

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

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Purpose: : To evaluate the risk of and risk factors for hypotony among patients with uveitis.

Methods: : Retrospective cohort study. Intra ocular pressures (IOP) and other characteristics of patients with non-infectious uveitis undergoing treatment at 5 academic ocular inflammation clinics were abstracted in standardized chart reviews of every eye at every visit. Hypotony was defined as a sustained IOP of <5mmHg in two consecutive visits or more over a period not less than 28 days. Survival analysis was used to estimate the incidence of hypotony and the adjusted hazard (HR) associated with potential risk factors.

Results: : After excluding eyes that had undergone glaucoma surgery, those presenting with hypotony, and those without follow up, hypotony occurred in 128 of 6,796 eyes (20,972 eye years) with an overall incidence rate of 0.61% (95% CI 0.50 - 0.75) per eye year. The youngest age group (<18 years vs 26-35 years (reference group); HR=5.05, 95% CI 2.63-9.69), hypertension (HR=2.02, 95% CI 1.02-3.99), longer duration of uveitis at cohort entry (>5 years vs <6 months HR=2.89, 95% CI 1.21- 6.87), prior cataract surgery (HR=8.77, 95% CI 4.69-16.42), vitreous cells ( 3+ or more vs none , HR=4.33, 95% CI 2.00-9.37), band keratopathy (HR=3.11, 95% CI 1.40-6.88) and exudative retinal detachment (HR=5.87, 95% CI 2.32-14.82) were associated with increased hypotony risk. Intermediate uveitis (HR=0.17, 95% CI 0.05 - 0.57) and posterior uveitis (HR=0.11, 95% CI 0.03 - 0.45) had much lower risk of hypotony than anterior uveitis (reference group) or panuveitis (HR=1.24, 95%CI 0.67 - 2.31).

Conclusions: : Our results suggest that younger age at presentation, systemic hypertension, longer duration of disease, and several factors indicating disease severity or chronicity were associated with increased risk of hypotony. Prior cataract surgery was the strongest risk factor, and sites of uveitis sparing the ciliary body were associated with much lower risk.

Keywords: intraocular pressure • uveitis-clinical/animal model • inflammation 

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