Approach to The Patient With Hypertensive Uveitis and Uveitic Glaucoma
DOI:
https://doi.org/10.58931/cect.2025.4260Abstract
Elevated intraocular pressure (IOP) and glaucomatous optic neuropathy are common complications in patients with uveitis. Ocular hypertension occurs in approximately 25% of uveitic patients. In addition, retrospective observational studies have found that 31-77% of patients with ocular hypertension had converted to glaucomatous optic neuropathy over a 10 year period. Ocular hypertension occurs in approximately 35% of children with uveitis, with secondary glaucoma occurring in 11-38%. Many of these children will require surgical glaucoma interventions: 11.5% at 1 year after a diagnosis of ocular hypertension, increasing to 50% by 5 years. In adults with non-infectious uveitis, the rate of surgical glaucoma interventions is between 20-40%.
References
Kanda T, Shibata M, Taguchi M, Ishikawa S, Harimoto K, Takeuchi M. Prevalence and aetiology of ocular hypertension in acute and chronic uveitis. Br J Ophthalmol. 2014;98(7):932-936. doi: 10.1136/bjophthalmol-2013-304416. Epub 2014 Mar 28. PMID: 24682184. DOI: https://doi.org/10.1136/bjophthalmol-2013-304416
Ma T, Sims JL, Bennett S, Chew S, Niederer RL. High rate of conversion from ocular hypertension to glaucoma in subjects with uveitis. Br J Ophthalmol. 2022;106(11):1520-1523. doi: 10.1136/bjophthalmol-2021-318809. Epub 2021 May 21. PMID: 34020941. DOI: https://doi.org/10.1136/bjophthalmol-2021-318809
Keorochana N, Treesit I, Funarunart P. Characteristics and clinical outcomes of hypertensive anterior uveitis. Ocul Immunol Inflamm. 2020;28(4):538-548. doi: 10.1080/09273948.2019.1587471. DOI: https://doi.org/10.1080/09273948.2019.1587471
Sijssens KM, Rothova A, Berendschot TT, de Boer JH. Ocular hypertension and secondary glaucoma in children with uveitis. Ophthalmology. 2006;113(5):853-859.e2. doi: 10.1016/j.ophtha.2006.01.043. PMID: 16650683. DOI: https://doi.org/10.1016/j.ophtha.2006.01.043
Gautam Seth N, Yangzes S, Thattaruthody F, Singh R, Bansal R, et al. Glaucoma secondary to uveitis in children in a tertiary care referral center. Ocul Immunol Inflamm. 2019;27(3):456-464. doi: 10.1080/09273948.2017.1411517. DOI: https://doi.org/10.1080/09273948.2017.1411517
Tan SZ, Yau K, Steeples LR, Ashworth J, Fenerty C, Jones N. Incidence, management and outcome of raised intraocular pressure in childhood-onset uveitis at a tertiary referral centre. Br J Ophthalmol. 2019;103(6):748-752. doi: 10.1136/bjophthalmol-2018-312498. DOI: https://doi.org/10.1136/bjophthalmol-2018-312498
Dick AD, Tundia N, Sorg R, Zhao C, Chao J, Joshi A, et al. Risk of ocular complications in patients with noninfectious intermediate uveitis, posterior uveitis, or panuveitis. Ophthalmology. 2016;123(3):655-662. doi: 10.1016/j.ophtha.2015.10.028. Erratum in: Ophthalmology. 2016;123(11):2439. doi: 10.1016/j.ophtha.2016.09.006. DOI: https://doi.org/10.1016/j.ophtha.2015.10.028
Kesav N, Palestine AG, Kahook MY, Pantcheva MB. Current management of uveitis-associated ocular hypertension and glaucoma. Surv Ophthalmol. 2020;65(4):397-407. doi: 10.1016/j.survophthal.2019.12.003. DOI: https://doi.org/10.1016/j.survophthal.2019.12.003
Keith Barton, Moorfields Eye Hospital, and Gary Holland, Stein Eye Institute. AAO course of Uveitic Glaucoma, 2021.
Jones NP, editor. Uveitis. 2nd ed. London, UK: Elsevier; 2019.
Marchese A, Di Biase C, Cicinelli MV, Menean M, Ferrari G, Bandello F, et al. Anterior segment involvement in vitreoretinal lymphoma: clinical manifestations, molecular findings and in vivo confocal microscopy. Br J Ophthalmol. 2024;108(8):1168-1171. doi: 10.1136/bjo-2023-324303. DOI: https://doi.org/10.1136/bjo-2023-324303
McKay KM, Lim LL, Van Gelder RN. Rational laboratory testing in uveitis: a Bayesian analysis. Sure Ophthalmol. 2021;66(5):802-825. doi:10.1016/j.survophthal.2021.02.002. DOI: https://doi.org/10.1016/j.survophthal.2021.02.002
Chronopoulos A, Roquelaure D, Soueyrand G, Seebach JD, Schultz JS, Thumann G. Aqueous humor polymerase chain reaction in uveitis - utility and safety. BMC Ophthalmol. 2016;16(1):189. doi: 10.1186/s12886-016-0369-z. DOI: https://doi.org/10.1186/s12886-016-0369-z
Standardization of Uveitis Nomenclature (SUN) Working Group. Classification criteria for Fuchs uveitis syndrome. Am J Ophthalmol. 2021;228:262-267. doi:10.1016/j.ajo.2021.03.052. DOI: https://doi.org/10.1016/j.ajo.2021.03.052
Sun Y, Ji Y. A literature review on Fuchs uveitis syndrome: an update. Surv Ophthalmol. 2020;65(2):133-143. doi: 10.1016/j.survophthal.2019.10.003. DOI: https://doi.org/10.1016/j.survophthal.2019.10.003
Tomkins-Netzer O, Niederer R, Lightman S. Uveitis Management. A Clinical Handbook. World Scientific Publishing; 2023. doi: 10.1142/12701 DOI: https://doi.org/10.1142/12701
Thng ZX, Putera I, Testi I, Chan K, Westcott M, Chee SP, et al. The Infectious Uveitis Treatment Algorithm Network (TITAN) Report 1-global current practice patterns for the management of Herpes Simplex Virus and Varicella Zoster Virus anterior uveitis. Eye (Lond). 2024;38(1):61-67. doi: 10.1038/s41433-023-02630-9. DOI: https://doi.org/10.1038/s41433-023-02630-9
Thng ZX, Putera I, Testi I, Chan K, Westcott M, Chee SP, et al. The Infectious Uveitis Treatment Algorithm Network (TITAN) Report 2-global current practice patterns for the management of cytomegalovirus anterior uveitis. Eye (Lond). 2024;38(1):68-75. doi: 10.1038/s41433-023-02631-8. DOI: https://doi.org/10.1038/s41433-023-02631-8
La Distia Nora R, Putera I, Mayasari YD, Hikmahwati W, Pertiwi AM, et al. Clinical characteristics and treatment outcomes of cytomegalovirus anterior uveitis and endotheliitis: a systematic review and meta-analysis. Surv Ophthalmol. 2022;67(4):1014-1030. doi: 10.1016/j.survophthal.2021.12.006. DOI: https://doi.org/10.1016/j.survophthal.2021.12.006
Hu J, Vu JT, Hong B, Gottlieb C. Uveitis and cystoid macular oedema secondary to topical prostaglandin analogue use in ocular hypertension and open angle glaucoma. Br J Ophthalmol. 2020;104(8):1040-1044. doi: 10.1136/bjophthalmol-2019-315280. DOI: https://doi.org/10.1136/bjophthalmol-2019-315280
Sng CC, Barton K. Mechanism and management of angle closure in uveitis. Curr Opin Ophthalmol. 2015;26(2):121-127. doi: 10.1097/ICU.0000000000000136. PMID: 25611167. DOI: https://doi.org/10.1097/ICU.0000000000000136
Bouhout S, Bachour K, Harasymowycz P, Jaworski L, Wang Q, Durr GM. Gonioscopy-assisted transluminal trabeculotomy in uveitis-related ocular hypertension and glaucoma. J Glaucoma. 2024;33(6):464-472. doi: 10.1097/IJG.0000000000002376. DOI: https://doi.org/10.1097/IJG.0000000000002376
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Canadian Eye Care Today
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
