Characteristics of ocular hypertension and uveitic glaucoma among patients with noninfectious uveitis

Tina Felfeli; Jess Rhee; Arshia Eshtiaghi; Michael Balas; Felicia Tai; Alexander J Kaplan; Panos G Christakis; Efrem D Mandelcorn; Laurence A Rubin; Nupura K Bakshi; Larissa A Derzko-Dzulynsky

doi:10.1016/j.jcjo.2024.02.003

Characteristics of ocular hypertension and uveitic glaucoma among patients with noninfectious uveitis

Can J Ophthalmol. 2024 Feb 29:S0008-4182(24)00035-8. doi: 10.1016/j.jcjo.2024.02.003. Online ahead of print.

Authors

Affiliations

¹ Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON; Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, ON. Electronic address: tina.felfeli@mail.utoronto.ca.
² Faculty of Medicine, Schulich School of Medicine and Dentistry, London, ON.
³ Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON.
⁴ The Temerty Faculty of Medicine, University of Toronto, Toronto, ON.
⁵ Division of Ophthalmology, McMaster University, Hamilton, ON.
⁶ Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON; Department of Ophthalmology, Toronto Western Hospital, University Health Network, Toronto, ON; The Kensington Vision and Research Centre, Kensington Health Institute, Toronto, ON.
⁷ Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON; The Kensington Vision and Research Centre, Kensington Health Institute, Toronto, ON.
⁸ Faculty of Medicine, Schulich School of Medicine and Dentistry, London, ON; Division of Rheumatology, St. Michael's Hospital, Unity Health Toronto, Toronto, ON.
⁹ Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON; The Kensington Vision and Research Centre, Kensington Health Institute, Toronto, ON; Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, ON; Department of Ophthalmology, Mount Sinai Hospital, ON.
¹⁰ Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON; The Kensington Vision and Research Centre, Kensington Health Institute, Toronto, ON; Department of Ophthalmology, St. Michael's Hospital, Unity Health Toronto, Toronto, ON.

PMID: 38431271
DOI: 10.1016/j.jcjo.2024.02.003

Abstract

Objective: Ocular hypertension and uveitic glaucoma are important downstream sequela of noninfectious uveitis (NIU). Herein, we describe the clinical outcomes of NIU cases with ocular hypertension and uveitic glaucoma.

Design: Retrospective cohort study.

Participants: All adults (≥18 years) with NIU under the care of uveitis subspecialty tertiary care clinics between 2010 and 2021 were included.

Methods: The primary outcomes were baseline and final visual acuity.

Results: A total of 216 patients out of 914 (23.6%) cases with NIU had ocular hypertension or uveitic glaucoma over the study period. Of all patients with ocular hypertension or uveitic glaucoma, 46% were corticosteroid responders. Baseline and last median visual acuities were better for the ocular hypertension patients compared with patients with uveitic glaucoma (p < 0.001). A higher proportion of patients with uveitic glaucoma than patients with ocular hypertension required glaucoma surgery (p < 0.001). The regression analyses suggested that baseline visual acuity and anatomical classification are significant predictors of last visual acuity, whereas diagnosis of ocular hypertension versus uveitic glaucoma were significant predictors of requirement for glaucoma surgery (p < 0.001).

Conclusion: A quarter of patients with NIU in this study developed ocular hypertension or uveitic glaucoma. Approximately half of the patients with ocular hypertension or uveitic glaucoma were deemed to be corticosteroid responders. Baseline and last visual acuity outcomes are better amongst ocular hypertension patients compared with those with uveitic glaucoma. Poor baseline visual acuity and panuveitis are predictors of worse vision at last follow-up. Additionally, diagnosis of uveitic glaucoma was a significant predictor of requirement for glaucoma surgery.