Purchase this article with an account.
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.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the risk of and risk factors for hypotony among patients with uveitis.
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.
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).
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.
This PDF is available to Subscribers Only