Abstract
Purpose :
To evaluate the risk of intraocular pressure (IOP) elevation associated with use of topical difluprednate 0.05% in children with uveitis, and to compare the effect in different pediatric age groups.
Methods :
In a retrospective observational cohort study, we evaluated 33 eyes of 22 children (<18 years of age) treated with topical difluprednate for non-infectious uveitis at the UCLA Stein Eye Institute. The primary outcome measure was IOP elevation ≥21 mmHg and a ≥10 mmHg increase from treatment initiation, which together were considered to be clinically important changes in IOP. A subanalysis investigated the effect in younger (<12 years of age; n=16 eyes, 9 patients) and in older age (≥12 years of age; n=17 eyes, 13 patients) groups.
Results :
Median age of patients was 11.7 years; 11 of 22 (50%) were female. The primary outcome was observed in 19/33 eyes (58%), with a median time to event of 23 days (IQR 14, 48). At the time of IOP elevation, median IOP was 32 mmHg (IQR 27, 36), and median increase from baseline was 17 mmHg (IQR 11, 20). The IOP outcome measure occurred in 12 of 16 eyes (75%) in the younger group versus 7 of 17 eyes (41%) in the older group. Incidence per 30 days was 0.23 for all patients, 0.48 for the younger group versus 0.12 for the older group (p=0.006). The time-to-event hazard ratio for the younger group was 4.6 (95% CI 1.4, 14.9; p=0.001) compared to the older group.
Conclusions :
IOP elevation in children with uveitis undergoing treatment with difluprednate is common; close monitoring of this population for IOP elevation and secondary glaucoma is critical. Younger children are at higher risk of developing IOP elevation, and the event occurs sooner after treatment initiation in younger patients.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.