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Ocular Hypotony in Patients With Juvenile Idiopathic Arthritis-Associated Uveitis.
Am J Ophthalmol. 2017 Jan; 173:45-55.AJ

Abstract

PURPOSE

To analyze occurrence, risk factors, and course of ocular hypotony (OH) in juvenile idiopathic arthritis-associated uveitis (JIAU).

DESIGN

Cohort study.

METHODS

Epidemiologic and ophthalmologic data at baseline and during follow-up of JIAU patients with and without ocular hypotony were evaluated.

RESULTS

OH developed in 57 of the 365 JIAU patients during the follow-up (mean 4.5 ± 3.5 years). In 40 patients with follow-up ≥12 months, OH was unrelated to previous ocular surgery: risk factors at baseline (univariate logistic regression analysis) included longer total duration of uveitis (odds ratio [OR] 1.13, P < .001), bilateral uveitis (OR 3.51, P = .009), low visual acuity (OR 5.1, P = .001), high laser-flare (LF) values (OR 1.74, P = .01), and presence of posterior synechiae (OR 3.28, P = .004). Increased anterior chamber (AC) cell and LF values were observed within 3 months prior to onset of transient (≤3 months; 37.5%) or persistent OH (>3 months; 62.5%). AC cell and LF values decreased within 3 months after onset of transient OH, while LF levels remained elevated ≥12 months in persistent OH. Optic disc edema and epiretinal membrane formation was found more frequently after OH onset.

CONCLUSIONS

OH was observed in 15.6% of JIAU patients. Longer total uveitis duration, bilateral uveitis, low visual acuity, high AC flare and LF grades, and presence of posterior synechiae at baseline were risk factors for subsequent OH. Burden of OH might be improved with immunosuppression.

Authors+Show Affiliations

Department of Ophthalmology, at St. Franziskus Hospital, Muenster, Germany. Electronic address: Michael.boehm@uk-essen.de.Department of Ophthalmology, at St. Franziskus Hospital, Muenster, Germany; Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.Department of Ophthalmology, at St. Franziskus Hospital, Muenster, Germany.Department of Ophthalmology, at St. Franziskus Hospital, Muenster, Germany.Department of Ophthalmology, at St. Franziskus Hospital, Muenster, Germany; University of Duisburg-Essen, Essen, Germany.Department of Ophthalmology, at St. Franziskus Hospital, Muenster, Germany; University of Duisburg-Essen, Essen, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27664701

Citation

Böhm, Michael R R., et al. "Ocular Hypotony in Patients With Juvenile Idiopathic Arthritis-Associated Uveitis." American Journal of Ophthalmology, vol. 173, 2017, pp. 45-55.
Böhm MR, Tappeiner C, Breitbach MA, et al. Ocular Hypotony in Patients With Juvenile Idiopathic Arthritis-Associated Uveitis. Am J Ophthalmol. 2017;173:45-55.
Böhm, M. R., Tappeiner, C., Breitbach, M. A., Zurek-Imhoff, B., Heinz, C., & Heiligenhaus, A. (2017). Ocular Hypotony in Patients With Juvenile Idiopathic Arthritis-Associated Uveitis. American Journal of Ophthalmology, 173, 45-55. https://doi.org/10.1016/j.ajo.2016.09.018
Böhm MR, et al. Ocular Hypotony in Patients With Juvenile Idiopathic Arthritis-Associated Uveitis. Am J Ophthalmol. 2017;173:45-55. PubMed PMID: 27664701.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ocular Hypotony in Patients With Juvenile Idiopathic Arthritis-Associated Uveitis. AU - Böhm,Michael R R, AU - Tappeiner,Christoph, AU - Breitbach,Marc A, AU - Zurek-Imhoff,Beatrix, AU - Heinz,Carsten, AU - Heiligenhaus,Arnd, Y1 - 2016/09/21/ PY - 2016/03/06/received PY - 2016/09/13/revised PY - 2016/09/14/accepted PY - 2016/9/25/pubmed PY - 2017/6/3/medline PY - 2016/9/25/entrez SP - 45 EP - 55 JF - American journal of ophthalmology JO - Am J Ophthalmol VL - 173 N2 - PURPOSE: To analyze occurrence, risk factors, and course of ocular hypotony (OH) in juvenile idiopathic arthritis-associated uveitis (JIAU). DESIGN: Cohort study. METHODS: Epidemiologic and ophthalmologic data at baseline and during follow-up of JIAU patients with and without ocular hypotony were evaluated. RESULTS: OH developed in 57 of the 365 JIAU patients during the follow-up (mean 4.5 ± 3.5 years). In 40 patients with follow-up ≥12 months, OH was unrelated to previous ocular surgery: risk factors at baseline (univariate logistic regression analysis) included longer total duration of uveitis (odds ratio [OR] 1.13, P < .001), bilateral uveitis (OR 3.51, P = .009), low visual acuity (OR 5.1, P = .001), high laser-flare (LF) values (OR 1.74, P = .01), and presence of posterior synechiae (OR 3.28, P = .004). Increased anterior chamber (AC) cell and LF values were observed within 3 months prior to onset of transient (≤3 months; 37.5%) or persistent OH (>3 months; 62.5%). AC cell and LF values decreased within 3 months after onset of transient OH, while LF levels remained elevated ≥12 months in persistent OH. Optic disc edema and epiretinal membrane formation was found more frequently after OH onset. CONCLUSIONS: OH was observed in 15.6% of JIAU patients. Longer total uveitis duration, bilateral uveitis, low visual acuity, high AC flare and LF grades, and presence of posterior synechiae at baseline were risk factors for subsequent OH. Burden of OH might be improved with immunosuppression. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/27664701/Ocular_Hypotony_in_Patients_With_Juvenile_Idiopathic_Arthritis_Associated_Uveitis_ DB - PRIME DP - Unbound Medicine ER -