Risk of Hypotony in Juvenile Idiopathic Arthritis–Associated Uveitis

Ahmadreza Moradi, Inna G. Stroh, Ashvini K. Reddy, Dana M. Hornbeak, Theresa G. Leung, Bryn M. Burkholder, Jennifer E. Thorne

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Objective To describe risk factors for hypotony in patients with juvenile idiopathic arthritis (JIA)-associated uveitis. Design Retrospective cohort study. Methods All patients with JIA-associated uveitis (N = 108; affected eyes = 196) evaluated and followed at the Wilmer Eye Institute from July 1984 through June 2014 were included in this study. Prevalence and incidence of hypotony (intraocular pressure [IOP] <5 mm Hg) and low IOP (5 mm Hg ≤ IOP < 8 mm Hg) and risk factors for developing hypotony were analyzed. Results At presentation, 9.3% of patients (7.1% of affected eyes) had hypotony. During a median follow-up of 5.3 years, the rate of developing hypotony and low IOP were 0.04 per eye-year (/EY; 95% confidence interval [CI]: 0.02/EY, 0.05/EY) and 0.06/EY (95% CI: 0.04/EY, 0.08/EY), respectively. Risk factors for development of hypotony during follow-up appeared to be associated with more severe uveitic disease, such as the presence of panuveitis (adjusted hazard ratio [aHR], 43.1; P = .004), anterior chamber cells or flare ≥ 3+ (aHR, 25.6, P < .001), posterior synechiae (aHR, 5.9, P = .02), and the use of oral corticosteroid (aHR 28.9; P = .003) at the presenting examination. Receiving immunosuppressive drug therapy at the time of presentation was associated with a lower risk of development of hypotony (aHR, 0.02; P = .002). Conclusions Hypotony affects a small but significant proportion of patients with JIA-associated uveitis and is associated with signs of active and severe uveitis. Immunosuppression was associated with significantly lower risk of hypotony, suggesting that aggressive control of the inflammation may reduce risk of hypotony in JIA-associated uveitis.

Original languageEnglish (US)
Pages (from-to)113-124
Number of pages12
JournalAmerican Journal of Ophthalmology
Volume169
DOIs
StatePublished - Sep 1 2016
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology

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    Moradi, A., Stroh, I. G., Reddy, A. K., Hornbeak, D. M., Leung, T. G., Burkholder, B. M., & Thorne, J. E. (2016). Risk of Hypotony in Juvenile Idiopathic Arthritis–Associated Uveitis. American Journal of Ophthalmology, 169, 113-124. https://doi.org/10.1016/j.ajo.2016.06.026