St Thomas Hospital, London, United Kingdom; King's College London, London, United Kingdom.
St Thomas Hospital, London, United Kingdom.
Am J Ophthalmol. 2019 Dec;208:347-355. doi: 10.1016/j.ajo.2019.08.018. Epub 2019 Aug 30.
To investigate aqueous humor dynamics in uveitic eyes.
Cross-sectional study.
Patients with recurrent (≥3 attacks) anterior uveitis (now quiescent) and being treated for glaucoma or ocular hypertension (OHT) (Group 1), previous recurrent anterior uveitis (≥3 attacks) without glaucoma or OHT (Group 2), and normal subjects with no ocular problems and IOP < 21 mm Hg at screening (control group; Group 3).
Patients had one-off measurements. Group 1 patients who were on antihypertensives were washed out for a 4-week period, prior to their study measurements. Main outcome measures were tonographic outflow facility, aqueous humor flow rate, and uveoscleral outflow.
One hundred and one patients were screened between February 2014 and February 2017. Nine patients did not meet the inclusion criteria. Groups 1 and 3 each included 30 patients, and Group 2 included 32 patients. The mean intraocular pressure was higher in Group 1 compared to the others (25 ± 10.2 mm Hg in Group 1 vs 16 ± 2.7 mm Hg in Group 2 vs 16 ± 2.2 mm Hg in Group 3, P < .001). The tonographic outflow facility was lower in Group 1 compared to the others (0.18 ± 0.1 μL/min/mm Hg in Group 1 vs 0.25 ± 0.1 μL/min/mm Hg in Group 2 vs 0.27 ± 0.1 μL/min/mm Hg in Group 3, P = .005). However, aqueous humor flow rate was not statistically different (2.47 ± 0.9 μL/min in Group 1 vs 2.13 ± 0.9 μL/min in Group 2 vs 2.25 ± 0.7 μL/min in Group 3, P = .3). There was also no significant difference in calculated uveoscleral outflow.
This is the first aqueous humor dynamics study in patients with uveitic glaucoma/OHT and recurrent anterior uveitis compared with age-matched controls. We have demonstrated that the elevated intraocular pressure seen in the uveitic glaucoma/OHT eyes (3-6 attacks) was due to reduced tonographic outflow facility. The aqueous humor flow rate was not detectibly different, nor did the calculated uveoscleral outflow demonstrate any discernible difference. However, the exact mechanism remains to be elucidated.
研究葡萄膜炎眼房水动力学。
横断面研究。
患有复发性（≥3 次）前部葡萄膜炎（现已缓解）并接受青光眼或眼高压（OHT）治疗的患者（第 1 组）、以前患有复发性前部葡萄膜炎（≥3 次）但无青光眼或 OHT 的患者（第 2 组）和无眼部问题且筛选时眼压（IOP）<21mmHg 的正常受试者（对照组；第 3 组）。
患者进行一次性测量。第 1 组接受抗高血压治疗的患者在研究测量前进行了为期 4 周的洗脱期。主要观察指标为眼压流出系数、房水流量和葡萄膜巩膜流出量。
2014 年 2 月至 2017 年 2 月期间共筛查了 101 例患者。9 例患者不符合纳入标准。第 1 组和第 3 组各包括 30 例患者，第 2 组包括 32 例患者。与其他两组相比，第 1 组的平均眼压更高（第 1 组 25±10.2mmHg，第 2 组 16±2.7mmHg，第 3 组 16±2.2mmHg，P<0.001）。与其他两组相比，第 1 组的眼压流出系数较低（第 1 组 0.18±0.1μL/min/mm Hg，第 2 组 0.25±0.1μL/min/mm Hg，第 3 组 0.27±0.1μL/min/mm Hg，P=0.005）。然而，房水流量没有统计学差异（第 1 组 2.47±0.9μL/min，第 2 组 2.13±0.9μL/min，第 3 组 2.25±0.7μL/min，P=0.3）。计算得出的葡萄膜巩膜流出量也没有明显差异。
这是首次对患有葡萄膜炎性青光眼/OHT 和复发性前部葡萄膜炎的患者与年龄匹配的对照组进行房水动力学研究。我们已经证明，在患有葡萄膜炎性青光眼/OHT 的眼中（3-6 次发作）看到的升高的眼内压是由于眼压流出系数降低所致。房水流量没有明显差异，计算得出的葡萄膜巩膜流出量也没有明显差异。然而，确切的机制仍有待阐明。
