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Jordan Marie Comstock, Sapna Gangaputra, Qingxia Chen, Karen M Joos; Long-term Outcomes of Inflammatory Glaucoma/Ocular Hypertension in Children. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3186 – A0412.
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© ARVO (1962-2015); The Authors (2016-present)
Pediatric uveitic glaucoma is a complex interplay between structural change from the disease process as well as the treatment options. We hypothesize that early treatment and regular monitoring with therapeutic adjustments by a glaucoma and uveitis specialist team will lead to long-term visual acuity, inflammatory, and intraocular pressure stability.
Records of pediatric uveitic glaucoma patients with at least 5 years of surveillance beginning in 2000 at a single-site center were retrospectively analyzed following Vanderbilt IRB approval (211820). Outcomes including vision, inflammatory presence, and IOP, along with required medical and surgical therapies, were assessed at 5 years and 7 years of follow-up.
19 children (33 involved eyes) met criteria for inclusion with 14 patients (23 eyes) having data at 7 years. 12.9% and 17.4% eyes had a ≥ 2-line visual acuity decline at 5 and 7 years, respectively. One patient returned legally blind OU after a 7-year hiatus. 77.4% and 91.3% eyes had no observable inflammation at 5 and 7 years, respectively. 83.3% and 78.6% patients were on immunomodulatory therapy, 5.6% and 7.1% patients were on oral steroids, 32.3% and 52.2% eyes were on topical steroids, and 26.3% and 57.1% eyes were on glaucoma meds at 5 and 7 years, respectively. IOP (6-21 mmHg) occurred in 96.8% and 78.3% eyes at 5 and 7 years, respectively. 16 eyes (51.6%) required glaucoma shunt surgery by 5 years. 4 eyes (25%) required repeat surgery.
Historically, patients with uveitic glaucoma had poor outcomes with limited therapies. However, our study indicated that children with inflammatory glaucoma have good long-term outcomes with uveitis and glaucoma team care. Maintaining IOP in our cohort required adjusting glaucoma medication needs and/or surgical intervention. Regular monitoring with therapeutic adjustments for inflammatory and IOP control in pediatric uveitic glaucoma can maintain vision.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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