Böhm Michael R R, Tappeiner Christoph, Breitbach Marc A, Zurek-Imhoff Beatrix, Heinz Carsten, Heiligenhaus Arnd
Department of Ophthalmology, at St. Franziskus Hospital, Muenster, Germany.
Department of Ophthalmology, at St. Franziskus Hospital, Muenster, Germany; Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Am J Ophthalmol. 2017 Jan;173:45-55. doi: 10.1016/j.ajo.2016.09.018. Epub 2016 Sep 21.
To analyze occurrence, risk factors, and course of ocular hypotony (OH) in juvenile idiopathic arthritis-associated uveitis (JIAU).
Cohort study.
Epidemiologic and ophthalmologic data at baseline and during follow-up of JIAU patients with and without ocular hypotony were evaluated.
OH developed in 57 of the 365 JIAU patients during the follow-up (mean 4.5 ± 3.5 years). In 40 patients with follow-up ≥12 months, OH was unrelated to previous ocular surgery: risk factors at baseline (univariate logistic regression analysis) included longer total duration of uveitis (odds ratio [OR] 1.13, P < .001), bilateral uveitis (OR 3.51, P = .009), low visual acuity (OR 5.1, P = .001), high laser-flare (LF) values (OR 1.74, P = .01), and presence of posterior synechiae (OR 3.28, P = .004). Increased anterior chamber (AC) cell and LF values were observed within 3 months prior to onset of transient (≤3 months; 37.5%) or persistent OH (>3 months; 62.5%). AC cell and LF values decreased within 3 months after onset of transient OH, while LF levels remained elevated ≥12 months in persistent OH. Optic disc edema and epiretinal membrane formation was found more frequently after OH onset.
OH was observed in 15.6% of JIAU patients. Longer total uveitis duration, bilateral uveitis, low visual acuity, high AC flare and LF grades, and presence of posterior synechiae at baseline were risk factors for subsequent OH. Burden of OH might be improved with immunosuppression.
分析青少年特发性关节炎伴发葡萄膜炎（JIAU）患者低眼压（OH）的发生率、危险因素及病程。
队列研究。
对有或无低眼压的JIAU患者在基线期及随访期间的流行病学和眼科数据进行评估。
在365例JIAU患者的随访期间（平均4.5±3.5年），有57例发生了低眼压。在随访时间≥12个月的40例患者中，低眼压与既往眼部手术无关：基线期的危险因素（单因素逻辑回归分析）包括葡萄膜炎总病程较长（比值比[OR]1.13，P<.001）、双侧葡萄膜炎（OR 3.51，P=.009）、视力低下（OR 5.1，P=.001）、激光散射（LF）值高（OR 1.74，P=.01）以及存在虹膜后粘连（OR 3.28，P=.004）。在短暂性（≤3个月；37.5%）或持续性低眼压（>3个月；62.5%）发作前3个月内观察到前房（AC）细胞和LF值增加。短暂性低眼压发作后3个月内AC细胞和LF值下降，而持续性低眼压中LF水平在发作后≥12个月仍保持升高。低眼压发作后更频繁地发现视盘水肿和视网膜前膜形成。
15.6%的JIAU患者出现了低眼压。葡萄膜炎总病程较长、双侧葡萄膜炎、视力低下、AC闪光和LF分级高以及基线期存在虹膜后粘连是随后发生低眼压的危险因素。免疫抑制可能会改善低眼压的负担。
