TY - JOUR
T1 - Risk of Hypotony in Juvenile Idiopathic Arthritis–Associated Uveitis
AU - Moradi, Ahmadreza
AU - Stroh, Inna G.
AU - Reddy, Ashvini
AU - Hornbeak, Dana M.
AU - Leung, Theresa Gan
AU - Burkholder, Bryn M.
AU - Thorne, Jennifer E.
N1 - Funding Information:
Funding/Support: Supported in part by the Kids Uveitis Research and Education (KURE) Fund at the Wilmer Eye Institute, Baltimore, Maryland. Financial disclosures: Jennifer E. Thorne: Funding from NEI, Allergan; Advisory Board Member for AbbVie and Xoma; Consultant for Gilead. The following authors have no financial disclosures: Ahmadreza Moradi, Inna G. Stroh, Ashvini K. Reddy, Dana M. Hornbeak, Theresa G. Leung, and Bryn M. Burkholder. All authors attest that they meet the current ICMJE criteria for authorship.
Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Objective To describe risk factors for hypotony in patients with juvenile idiopathic arthritis (JIA)-associated uveitis. Design Retrospective cohort study. Methods All patients with JIA-associated uveitis (N = 108; affected eyes = 196) evaluated and followed at the Wilmer Eye Institute from July 1984 through June 2014 were included in this study. Prevalence and incidence of hypotony (intraocular pressure [IOP] <5 mm Hg) and low IOP (5 mm Hg ≤ IOP < 8 mm Hg) and risk factors for developing hypotony were analyzed. Results At presentation, 9.3% of patients (7.1% of affected eyes) had hypotony. During a median follow-up of 5.3 years, the rate of developing hypotony and low IOP were 0.04 per eye-year (/EY; 95% confidence interval [CI]: 0.02/EY, 0.05/EY) and 0.06/EY (95% CI: 0.04/EY, 0.08/EY), respectively. Risk factors for development of hypotony during follow-up appeared to be associated with more severe uveitic disease, such as the presence of panuveitis (adjusted hazard ratio [aHR], 43.1; P = .004), anterior chamber cells or flare ≥ 3+ (aHR, 25.6, P < .001), posterior synechiae (aHR, 5.9, P = .02), and the use of oral corticosteroid (aHR 28.9; P = .003) at the presenting examination. Receiving immunosuppressive drug therapy at the time of presentation was associated with a lower risk of development of hypotony (aHR, 0.02; P = .002). Conclusions Hypotony affects a small but significant proportion of patients with JIA-associated uveitis and is associated with signs of active and severe uveitis. Immunosuppression was associated with significantly lower risk of hypotony, suggesting that aggressive control of the inflammation may reduce risk of hypotony in JIA-associated uveitis.
AB - Objective To describe risk factors for hypotony in patients with juvenile idiopathic arthritis (JIA)-associated uveitis. Design Retrospective cohort study. Methods All patients with JIA-associated uveitis (N = 108; affected eyes = 196) evaluated and followed at the Wilmer Eye Institute from July 1984 through June 2014 were included in this study. Prevalence and incidence of hypotony (intraocular pressure [IOP] <5 mm Hg) and low IOP (5 mm Hg ≤ IOP < 8 mm Hg) and risk factors for developing hypotony were analyzed. Results At presentation, 9.3% of patients (7.1% of affected eyes) had hypotony. During a median follow-up of 5.3 years, the rate of developing hypotony and low IOP were 0.04 per eye-year (/EY; 95% confidence interval [CI]: 0.02/EY, 0.05/EY) and 0.06/EY (95% CI: 0.04/EY, 0.08/EY), respectively. Risk factors for development of hypotony during follow-up appeared to be associated with more severe uveitic disease, such as the presence of panuveitis (adjusted hazard ratio [aHR], 43.1; P = .004), anterior chamber cells or flare ≥ 3+ (aHR, 25.6, P < .001), posterior synechiae (aHR, 5.9, P = .02), and the use of oral corticosteroid (aHR 28.9; P = .003) at the presenting examination. Receiving immunosuppressive drug therapy at the time of presentation was associated with a lower risk of development of hypotony (aHR, 0.02; P = .002). Conclusions Hypotony affects a small but significant proportion of patients with JIA-associated uveitis and is associated with signs of active and severe uveitis. Immunosuppression was associated with significantly lower risk of hypotony, suggesting that aggressive control of the inflammation may reduce risk of hypotony in JIA-associated uveitis.
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U2 - 10.1016/j.ajo.2016.06.026
DO - 10.1016/j.ajo.2016.06.026
M3 - Article
C2 - 27345732
AN - SCOPUS:84979503756
VL - 169
SP - 113
EP - 124
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -