Occurrence and management of ocular hypertension and secondary glaucoma in juvenile idiopathic arthritis-associated uveitis: An observational series of 104 patients

Kaisu Kotaniemi, Kristiina Sihto-Kauppi

Rheumatism Foundation Hospital, Heinola, Finland

Aims: To describe the development and management of ocular hypertension (OHT) and secondary glaucoma (SG) in patients with juvenile idiopathic arthritis (JIA)-associated uveitis.

Patients and methods: A series of 104 patients with newly diagnosed JIA and associated uveitis was collected in 1989–1996. A re-evaluation was made after mean 9.7 years (range 0.8–15.6 years) follow-up. OHT was diagnosed if intraocular pressure (IOP) had been ≥22 mmHg for longer than 3 months or when a single IOP was ≥30 mmHg despite normal visual field and optic disc. SG was diagnosed in a patient who had optic disc changes and/or visual field defects compatible with glaucoma.

Results: OHT or SG developed in 14 patients (14%, 22 eyes). IOP was under control (<22 mmHg) in 2 patients without treatment and in 3 patients with medication. Filtering surgery was performed in 9 patients, 5 of them needed additional glaucoma medication. The binocular visual acuity was 0.5 or better in all patients; in five eyes vision was less than 0.5, but no eye blinded.

Conclusion: OHT or SG in JIA patients with uveitis is a diagnostic and therapeutic challenge, but if the medical and surgical treatment is timed correctly, the sight can be saved in most patients.

Keywords: JIA, uveitis, glaucoma