Original articleOcular Hypotony in Patients With Juvenile Idiopathic Arthritis–Associated Uveitis
Section snippets
Methods
Medical records of all children with JIA-associated uveitis followed up between April 3, 2001 and November 28, 2013 at the Department of Ophthalmology at St. Franziskus Hospital, Muenster, Germany, were retrospectively reviewed. The study was conducted in accordance with the Declaration of Helsinki. Approval from the ethics committee is not required for retrospective chart reviews in Germany. Only patients who were referred to the uveitis center within the first year of uveitis onset were
Patient Characteristics
A total of 365 patients with JIA-associated uveitis were identified in the uveitis center database. Epidemiologic data for these patients are shown in Table 1. JIAU patients were predominantly of female sex (69.6%), had early onset of arthritis, and were ANA positive (74.5%), and the majority was classified as having persistent oligoarthritis (73.0%). In 150 patients (41.2%), uveitis-related secondary complications were documented already at baseline, for example, band keratopathy (17.5%),
Discussion
In this study we analyzed the occurrence and course of OH in a large cohort of JIAU at a single tertiary uveitis center. Up to now, only limited data on this issue were available for uveitis in general, and data for JIAU were even scarcer.15, 16, 28, 29, 30 In our study, we found an occurrence of OH in about 15% of our patients with JIAU (mean follow-up time 4.5 years), which was higher than in previous publications, where a prevalence of OH between 3% and 9% was reported.9, 13, 14, 15, 16 The
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Taiwan ocular inflammation society consensus recommendations for the management of juvenile idiopathic arthritis-associated uveitis
2024, Journal of the Formosan Medical AssociationPediatric uveitis: A comprehensive review
2022, Survey of OphthalmologyDescemet Membrane Endothelial Keratoplasty in Eyes With Chronic Ocular Hypotony Following Glaucoma Surgery
2021, American Journal of OphthalmologyCitation Excerpt :The current study shows that in the vast majority of cases, visual acuity improved after surgery, with survival probability that was similar to that described for nonhypotonic eyes after glaucoma procedures.24 Post-trabeculectomy/tube hypotonic eyes frequently have associated problems such as hypotonic maculopathy,29,30 optic disc edema,31 and choroidal folds,32 in addition to coexisting visual field damage. All of these can further limit visual potential after DMEK, and the risks and expectations should be discussed with the patient, especially in monocular patients.
Update of the evidence based, interdisciplinary guideline for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis
2019, Seminars in Arthritis and RheumatismCitation Excerpt :Presence of these risk factors point to the severity of the disease and, in the view of the guideline group, represent a criterion for DMARD treatment. On the other hand, anti-inflammatory therapy should be initiated or intensified without the presence of AC cells if macular edema, ocular hypotony [12,159], or iris rubeosis are demonstrated, as these often correlate with chronic inflammation of the affected tissues. Topical corticosteroids shall be used as initial treatment for active uveitis.
Ocular hypotony: A comprehensive review
2019, Survey of OphthalmologyCitation Excerpt :Hypotony in children is recognized as a potential complication of uveitis, and the propensity for developing hypotony is higher compared to adults. Hypotony is seen in 9–15% of children with juvenile idiopathic arthritis-associated uveitis.215,330,40 Risk factors include bilateral uveitis, panuveitis, high anterior chamber flare, posterior synechiae, and a longer total duration of uveitis.215,40
Michael R.R. Böhm is currently affiliated with the Department of Ophthalmology, Clinic for Diseases of the Anterior Segments of the Eyes, Essen University Hospital, Essen, Germany.