The purpose of this retrospective study from two tertiary Institutions in Israel over a period of 13 years, is to present the long-term outcomes of uveitic glaucoma and to identify risk factors for progression. The study included 34 patients (53 eyes) with a mean follow-up of seven years. Idiopathic anterior uveitis and open angle glaucoma were the most common and 62% of eyes were steroid responders. Higher IOP was associated with posterior synechiae, peripheral anterior synechiae, steroidal and immunomodulatory therapy (p<0.05). Glaucomatous field defects developed in 49% with most showing no progression, despite elevation of cup to disc ratio (p<0.05). Cataract surgery was performed in 37 eyes (69%) and trabeculectomy in 17 eyes (32%). Fifteen eyes (28%) underwent both cataract and trabeculectomy surgery and in most cases the cataract (80%) was performed first. Three patients required repeat trabeculectomy. The authors note that because of the relatively small size of their cohort, they could not determine if cataract surgery was effective in lowering the IOP or if it was associated with filtering surgery. The authors conclude that chronic severe uveitis cases expressed by the presence of structural complications and the need of immunomodulation therapy is associated with raised IOP and the need for more IOP lowering medications. There is no association between severity of uveitis and glaucomatous damage.

Uveitic glaucoma: Long-term clinical outcomes and risk factors for progression.
Sharon Y, Friling R, Luski M, et al.
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Nikolaos D Georgakarakos

Moorfields Eye Hospital, London, UK.

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