Secondary glaucoma in patients with juvenile rheumatoid arthritis-associated iridocyclitis

Acta Ophthalmol Scand. 2000 Oct;78(5):576-9. doi: 10.1034/j.1600-0420.2000.078005576.x.

Abstract

Purpose: The prevalence and management of glaucoma were evaluated in patients with juvenile rheumatoid arthritis (JRA)-associated iridocyclitis.

Methods: The records of 69 patients with JRA-associated iridocyclitis were reviewed.

Results: Twenty-nine (42%) of these patients had secondary glaucoma or ocular hypertension. Glaucoma was controlled with topical treatment in only 7 of the 41 affected eyes (17%); systemic carbonic anhydrase inhibitor therapy resulted in control of another 8 eyes. Surgery controlled all but one of the remainder.

Conclusion: Glaucoma is a common complication of JRA-associated iridocyclitis. It results from prolonged, inadequately treated intraocular inflammation and in some instances, from steroid use. Medical and surgical therapy for the glaucoma associated with JRA-uveitis is challenging and incompletely effective. We suspect that a more aggressive approach to the treatment of JRA-associated uveitis, earlier in the course of the disease may reduce this vision robbing contribution to the process.

MeSH terms

  • Adolescent
  • Adrenergic beta-Antagonists / therapeutic use
  • Adult
  • Age of Onset
  • Aged
  • Arthritis, Juvenile / complications*
  • Arthritis, Juvenile / epidemiology
  • Arthritis, Juvenile / therapy
  • Boston / epidemiology
  • Carbonic Anhydrase Inhibitors / therapeutic use
  • Child
  • Child, Preschool
  • Female
  • Filtering Surgery
  • Follow-Up Studies
  • Glaucoma / epidemiology
  • Glaucoma / etiology*
  • Glaucoma / therapy
  • Humans
  • Iridocyclitis / epidemiology
  • Iridocyclitis / etiology*
  • Iridocyclitis / therapy
  • Male
  • Middle Aged
  • Ocular Hypertension / etiology
  • Ophthalmic Solutions
  • Prevalence
  • Visual Acuity

Substances

  • Adrenergic beta-Antagonists
  • Carbonic Anhydrase Inhibitors
  • Ophthalmic Solutions