Ocular hypertension and secondary glaucoma in children with uveitis.

PURPOSE

To identify the risk factors for ocular hypertension and secondary glaucoma in children with uveitis.

DESIGN

Retrospective observational case series of 147 patient records.

PARTICIPANTS

Two hundred fifty-six eyes of 147 children with uveitis diagnosed before the age of 16 years.

METHODS

Data were obtained from the medical records of children with uveitis evaluated at our institute from 1990 through 2004.

MAIN OUTCOME MEASURES

Localization and course of uveitis (acute or chronic), underlying systemic disease, onset of ocular hypertension, onset of secondary glaucoma, treatment with steroids, antinuclear antibodies (ANAs), lens extractions, number of blind eyes at onset and during follow-up, and the duration of follow-up.

RESULTS

Elevated intraocular pressure developed in 35% of children with pediatric uveitis regardless of the form or type of uveitis during a follow-up of 5 years. Secondary glaucoma, however, developed more frequently in juvenile idiopathic arthritis-associated uveitis (38%) compared with other forms of uveitis (11%) and more frequently in children with uveitis who were ANA positive (42%) than in those who were ANA negative (6%). Elevated intraocular pressure occurred in two thirds of all children within the first 2 years after the diagnosis of uveitis. Except for patients with juvenile idiopathic arthritis-associated uveitis, periocular steroid injections represented an additional risk factor for secondary glaucoma, but this risk was limited to the early phase of the disease process.

CONCLUSIONS

In children with uveitis in this series, juvenile idiopathic arthritis-associated uveitis and ANA-positive uveitis without evidence of arthritis are the most important risk factors for developing secondary glaucoma.