Abstract
• Objectives: (1) To prospectively evaluate the incidence of increased intraocular pressure (IOP) in patients suffering from chronic uveitis. (2) To identify the main factors responsible for an increase in the IOP among these patients. • Methods: Two hundred and one patients suffering from chronic uveitis were included. Enrolled patients had an initial IOP of 8–18 mmHg. The patients were treated and clinically monitored during a period of 4 years. The IOP was measured at each visit and its changes followed prospectively. All patients were followed up for at least 12 months after enrollment. • Results: Twenty-four (12%) of the 201 patients had IOP higher than 24 mmHg at two or more consecutive visits. Of these 24 patients, 19 suffered from bilateral uveitis and 5 had unilateral disease. Four of the 19 patients with bilateral uveitis developed a constant IOP higher than 24 mmHg in both eyes, while in 15 patients an IOP higher than 24 mmHg persisted only in one eye. A close association between the increased IOP and the use of corticosteroids was found in 18 of the 24 cases (75%). This association was ascertained in 16 of these patients by the decrease in IOP levels on discontinuation of the corticosteroid regimen and the renewed increase in IOP on rechallenge. The increased IOP was due to pupillary block in three cases (12.5%), to iris and angle neovascularization in two (8.3%), and to the inflammatory process per se in one case only (4.2%). • Conclusions: This study demonstrates that a persistent elevation of the IOP in patients suffering from chronic uveitis is, in the majority of cases, associated with the use of corticosteroids.
Similar content being viewed by others
References
Armaly MF (1963) Effect of corticosteroids on intraocular pressure and fluid dynamics. I. The effect of dexamethasone in the normal eye. Arch Ophthalmol 70:482–491
Armaly MF (1963) Effect of corticosteroids on intraocular pressure and fluid dynamics. II. The effect of dexamethasone in the glaucomatous eye. Arch Ophthalmol 70:492–499
Becker B, Mills DW (1963) Corticosteroids and intraocular pressure. Arch Ophthalmol 70:500–507
BenEzra D (1980) Diseases of the choroid and anterior uvea. In: Michaelson IC (ed) Michaelson's textbook of the fundus of the eye, Churchill Livingstone, London, pp 667–712
BenEzra D (1991) Treatment aspects in ocular Behcet. Asia-Pacific J Ophthalmol 3:15–19
BenEzra D, Nussenblatt RB, Timonen P (1988) Optimal use of Sandimmun in endogenous uveitis. Springer, Berlin Heidelberg New York, pp 1–22
Chan CC, Palestine AG, Nussenblatt RB, Roberge FG, BenEzra D (1985) Anti-retinal auto-antibodies in Vogt-Koyanagi-Harada syndrome, Behcet's disease and sympathetic ophthalmia. Ophthalmology 92:1025–1928
Clark AF (1995) Steroids, ocular hypertension and glaucoma. J Glaucoma 4:354–369
Epstein DL, Hashimoto JM, Grant WM (1978) Serum obstruction of aqueous outflow in enucleated eyes. Am J Ophthalmol 86:101–105
Francois J (1977) Corticosteroid glaucoma. Ann Ophthalmol 9:1075–1080
Herman DC, Palestine AG, Nussenblatt RB (1988) Ocular fluorescein clearance in patients with hypotony secondary to chronic uveitis. J Ocul Pharmacol 4:327–333
Johnstone MA, Grant WG (1973) Pressure-dependent changes in structure of the aqueous outflow system of human and monkey eyes. Am J Ophthalmol 75:365–383
Kass MA, Podos SM, Moses RA, Becker B (1972) Prostaglandin E1 and aqueous human dynamics. Invest Ophthalmol 11:1022–1027
Mapstone R (1971) Vascular factors involved in aetiology of secondary glaucoma. Trans Ophthalmol Soc UK 91:741–748
Panek WC, Holland GN, Lee DA, Christensen RE (1990) Glaucoma in patients with uveitis. Br J Ophthalmol 74:223–227
Roth M, Simmons RJ (1979) Glaucoma associated with precipitates on the trabecular meshwork. Ophthalmology 86:1613–1619
Samples JR, Alexander JP, Acott TS (1993) Regulation of the levels of human trabecular matrix metalloproteinases and inhibitor by interleukin-7 and dexamethasone. Invest Ophthalmol Vis Sci 34:3386–3395
Zirm M (1982) Protein glaucoma — overtaxing of flow mechanisms? Preliminary report. Ophthalmologica 184:155–161
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
BenEzra, D., Wysenbeek, Y.S. & Cohen, E. Increased intraocular pressure during treatment for chronic uveitis. Graefe's Arch Clin Exp Ophthalmol 235, 200–203 (1997). https://doi.org/10.1007/BF00941759
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00941759