Abstract

SO.20.05

Corticosteroids and secondary glaucoma in patients with Fuchs heterochromic cyclitis and idiopathic chronic anterior uveitis

Carsten Heinz, Beatrix Zurek-Imhoff, Martin Rösel, Arnd Heiligenhaus
Augenabteilung am St. Franziskus Hospital Münster

Objective
Aim of this study was to assess frequency of elevated IOP (ocular hypertension OHT/ secondary glaucoma SG) in patients with Fuchs heterochromic cyclitis (FHC) and chronic anterior uveitis (CAU) in association with corticosteroid therapy
Methods
Monocenter retrospective analysis of patients with FHC and CAU. Assessment of optic neuropathy, intraocular pressure and topical and systemic corticosteroid therapy.
Results
Overall 46 (21 females) patients with FHC and 44 (26 females; p=0,21) with CAU were analyzed. Average age was similar in both groups (p= 0,06). OHT/SG was present in 17 (37%) of the FHC and in 8 (18%) of the CAU patients. Average follow-up time (FHC 148 months; CAU 149 months; p= 0,99) and elapsed time between diagnosis of uveitis and glaucoma (FHC 100 months; CAU 82 months; p= 0,65) were not different. The number of months on topical steroid therapy (FHC 54 months vs. CAU 20 months; p=0,024) and months of steroid therapy multiplied with the daily application frequency of maintenance therapy (FHC 158 vs. CAU 62; p=0,027) was significantly different. Univariate analysis of patients with OHT/SG revealed only age (p=0,002) in patients with FHC and month on topical steroid therapy (p=0,005) and the summed maintenance therapy (p=0,0003) in CAU patients to be associated with OHT/SG manifestation. Multivariate logistic regression showed also age (OR 1,12, 95%CI 1,03-1,21, p=0,006) in patients with FHC and number of months on topical therapy in CAU patients (OR 1,3, 95%CI 1,02-1,59, p=0,029) to be associated with OHT/SG manifestation.
Conclusions
OHT/SG is much more frequent in patients with FHC than in CAU patients. In patients with FHC age and in CAU patients the number of months on topical steroid therapy seems to be a risk factor for OHT/SG manifestation. These observations suggest different morphological changes in the trabecular meshwork of FHC and CAU patients.

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