Uveitic secondary glaucoma associated with Behcet's disease and Sarcoidosis

Abstract

Abstract: : Purpose: The purpose of this study is to clarify the differences in characteristics of uveitic secondary glaucoma (SG) between Behcet’s disease and Sarcoidosis, which are both idiopathic multi–system inflammatory disorder. Methods: The subjects were 276 eyes of 150 patients with uveitis associated with Behcet’s disease and 194 eyes of 98 patients with uveitis complicated with Sarcoidosis, at Tokyo Women’s Medical University, in a year of 2002. In this study, SG was defined as high ocular pressure uncontrolled more than one month or relapsed more than three times in a year, despite of aggressive medical therapy. We mainly compared two diseases by the components of IOL elevation such as inflammation and steroid. Results: 1)Frequency: SG were seen in twenty–five eyes (9.1%) of fourteen patients with Behcet’s disease, and thirteen eyes (6.7%) of ten patients with Sarcoidosis. 2) Relation between inflammation and IOP elevation: With active phase of inflammation, IOP tended to be high in many eye of SG with both diseases. In seven eyes (28%) with Behcet’s disease, lower IOP were remarkably observed rather with active phase than with inactive phase ; however, such a condition was not observed with Sarcoidosis(p<0.05). 3) Steroid–induced glaucoma: Frequency of steroid–induced SG was 51% with Behcet’s disease and 31% with Sarcoidosis. Differences of features between two diseases were not disclosed. 4) Non–steroid glaucoma : The latency period of IOP elevation from the onset of uveitis in Behcet’s disease (11.05±2.76 years ) (n=11) was significantly longer than that of Sarcoidosis (3.11±1.51 years) (n=9) ( P<0.05). Gonioscopy revealed open angles in 91% of non–steroid SG with Behcet’s disease and 22% of those with Sarcoidosis (p<0.01). Peripheral anterior synechia were observed in 27% of Behcet’s disease and in 100% of Sarcoidosis( p<0.005).These findings were significantly different between these two diseases. Conclusions: We suggest that although the clinical features of steroid–induced SG do not discriminate between these two diseases, non–steroid SG associated with Behcet’s disease should mechanically differ from those with Sarcoidosis.

Keywords: uveitis–clinical/animal model