Risk of elevated intraocular pressure and glaucoma in patients with uveitis: Results of the multicenter uveitis steroid treatment trial

David S Friedman, Janet Teresa Holbrook, Husam Ansari, Judith Alexander, Alyce Burke, Susan B. Reed, Joanne Katz, Jennifer Thorne, Susan L. Lightman, John H. Kempen, Douglas Jabs

Research output: Contribution to journalArticle

Abstract

Objective: To report the 2-year incidence of raised intraocular pressure (IOP) and glaucomatous optic nerve damage in patients with uveitis randomized to either fluocinolone acetonide (FA) implants or systemic therapy. Secondarily, we sought to explore patient and eye characteristics associated with IOP elevation or nerve damage. Design: A randomized, partially masked trial in which patients were randomized to either FA implants or systemic therapy. Participants: Patients aged ≥13 years with noninfectious intermediate, posterior, or panuveitis active within the prior 60 days for which systemic corticosteroids were indicated were eligible. Methods: Visual fields were obtained at baseline and every 12 months using the Humphrey 24-2 Swedish interactive threshold algorithm (SITA) fast protocol. Stereoscopic optic nerve photos were taken at baseline and at 3-, 6-, 12-, and 24-month follow-up visits. Masked examiners measured IOP at every study visit. Main Outcome Measures: Glaucoma was diagnosed based on an increase in optic nerve cup-to-disc ratio with visual field worsening or increased cup-to-disc ratio alone, for cases where visual field change was not evaluable, because of missing data or severe visual field loss at baseline. Results: Most patients were treated as assigned; among those evaluated for glaucoma, 97% and 10% of patients assigned to implant and systemic treatment, respectively, received implants. More patients (65%) assigned to implants experienced an IOP elevation of ≥10 mmHg versus 24% assigned to systemic treatment (P

Original languageEnglish (US)
Pages (from-to)1571-1579
Number of pages9
JournalOphthalmology
Volume120
Issue number8
DOIs
StatePublished - Aug 2013

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Uveitis
Intraocular Pressure
Glaucoma
Steroids
Visual Fields
Fluocinolone Acetonide
Optic Nerve
Therapeutics
Panuveitis
Adrenal Cortex Hormones
Outcome Assessment (Health Care)
Incidence

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Risk of elevated intraocular pressure and glaucoma in patients with uveitis : Results of the multicenter uveitis steroid treatment trial. / Friedman, David S; Holbrook, Janet Teresa; Ansari, Husam; Alexander, Judith; Burke, Alyce; Reed, Susan B.; Katz, Joanne; Thorne, Jennifer; Lightman, Susan L.; Kempen, John H.; Jabs, Douglas.

In: Ophthalmology, Vol. 120, No. 8, 08.2013, p. 1571-1579.

Research output: Contribution to journalArticle

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