Abstract

SO.20.06

Degree of inflammation at first elevation of intraocular pressure in patients with JIA associated anterior uveitis

Claudia Schumacher, Arnd Heiligenhaus, Carsten Heinz
Augenabteilung am St. Franziskus Hospital Münster

Objective
The pathomechanism of secondary glaucoma in children with juvenile idiopathic arthritis (JIA) associated anterior uveitis is unknown. Aim of this work is to assess the anterior chammber degree of inflammation at the initial elevation of intraocular pressure (IOP)
Methods
Retrospective analysis of 30 patients (24 girls, 42 affected eyes) with anterior uveitis and IOP elevation. Degree of inflammation (anterior chamber cells, laser flare photometry), IOP and optic disc cupping at first-time elevation of intraocular pressure as well as previous intraocular surgery were analyzed.
Results
10 (24%) eyes had active inflammation at the moment of first pressure elevation (IOP > 24 mmHg). 25 eyes (60%) merely had no inflammatory activity. 7 (16%) eyes underwent intraocular surgery before IOP rose. Groups did not differ according to age at onset of JIA (3,4 years active group, 4 years inactive group, 3 years surgery group). Patient with active inflammation developed IOP elevation earlier (8,3 years) compared to the inactive group (10,2 years) and the surgery group (12,6 years). Also the period of time was shorter between first diagnosis of JIA and uveitis (0,6 vs. 1,5 respective 2,3 years), and the mean time between uveitis and first IOP elevation in children with active inflammation (2,8 years) compared to children with inactive inflammation (3,3 years) or previous intraocular surgery (3,4 years). Corresponding to the low anterior chamber cellcount laserflare photometry was also lower (p< 0,001) in patients with inactive inflammation. Concerning optic disc excavation at the time of first IOP elevation there was no significant difference between the groups.
Conclusions
An elevation of intraocular pressure in anterior JIA associated uveitis was mostly observed after quiesence of inflammation. The pathomechanism remains still unclear. Rarely an increased protein level in the anterior chamber might be responsible for the pressure elevation. Pressure elevation after intraocular surgery might be of another different pathophysiology.

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