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Long-term prognosis for glaucoma in patients with Posner–Schlossman syndrome

Abstract

Background

The aim of this study is to investigate the long-term prognosis for glaucoma in patients with Posner–Schlossman syndrome (PSS).

Methods

In this retrospective case series study, a total of 98 patients with PSS from January 2014 to February 2019 were included in this study. Initial presentations and follow-up data were obtained from medical records. Vision-related quality of life (VR-QoL) was assessed using the 25-item National Eye Institute Visual Functioning Questionnaire.

Results

Of the 98 patients included in the study, 66 (67%) presented with glaucoma, and among them, 21 (32%) required glaucoma surgery. The mean follow-up time was 50.1 months (range 1–263 months). Iris involvement was noted in 46 (46.9%) eyes; 26 (26.5%) had sectoral iris changes and 20 (20.4%) showed diffuse iris changes. Eyes with iris involvement had a significantly higher number of acute attacks of uveitis than those without (p = 0.010). The 5-year glaucoma surgery-free interval was 77.8% according to Kaplan–Meier analysis. Significant predictors of glaucoma surgery included iris involvement (hazard ratio [HR] = 5.215; confidence interval [CI] = 1.387–19.610), highest number of anti-glaucoma agents (HR = 5.069; CI = 1.848–13.905), baseline average retinal nerve fiber layer thickness (RNFLT) thickness (HR = 0.949; CI = 0.917–0.982), and disease duration (HR = 0.977; CI = 0.957–0.996). Overall complete surgical success and qualified success at 2 years was 35.3% and 75.5%, respectively. Patients with iris involvement, glaucoma surgery, and thinner average RNFLT had significantly poorer VR-QoL (all, p < 0.05).

Conclusions

Patients with PSS and glaucoma required glaucoma surgery in a high rate. Iris involvement increased the probability of surgical treatment and lowered the VR-QoL of PSS patients.

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Acknowledgements

The English in this document has been checked by at least two professional editors, both native speakers of English. For a certificate, please see: http://www.textcheck.com/certificate/ebKl5n

Funding

This research was supported by National Research Foundation of Korea (NRF) (grant number 2019R1F1A1043806).

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Correspondence to Jin A. Choi.

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The study was conducted in accordance with the ethical standards of the Declaration of Helsinki and was approved by the Institutional Review Board of St. Vincent’s Hospital, the Catholic University, College of Medicine, which waived the written informed consent because of the study’s retrospective design.

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The authors declare no competing interests.

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Kim, JH., Lee, JY. & Choi, J.A. Long-term prognosis for glaucoma in patients with Posner–Schlossman syndrome. Graefes Arch Clin Exp Ophthalmol (2021). https://doi.org/10.1007/s00417-021-05291-0

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Keywords

  • Posner–Schlossman syndrome
  • Glaucoma surgery
  • Uveitis
  • Vision-related quality of life