Title: Secondary Glaucoma: Treatable Visual Threat in Uveitis?
Authors: Dr Sanjoy Chowdhury MS.DO.DNB,Dr Hitesh Patel, Dr Pratik Bhosale,Dr Kavita Prasad, Nilanjan Chowdhury
DOI: http://dx.doi.org/10.18535/jmscr/v3i9.29
Abstract
Background: Secondary Glaucoma, due to disease and drugs is an important cause of morbidity in uveitis.
Purpose: To evaluate prevalence of secondary glaucoma (SG) in uveitis with different treatment regimen
Methods: Randomised prospective hospital based study of uveitis from 2007-2012.Baseline IOP; Field and optic nerve head photographs were recorded. Three groups were randomised: 1.topical steroid 2.Systemic steroid +gr 1, 3.Topical synthetic steroids, cycloplegic and periorbital triamcinolone injection. IOP more than 22 mm/4 mm increase from baseline is marker.
Results: Study included 1254 cases of uveitis (prevalence rate 63/100000; Bokaro: n 2061918, census 2011) with 82 secondary glaucoma, 70% in anterior uveitis. During treatment, SG was maximum (80%) in first group and least (5%) with synthetic steroid combined with periorbital triamcinolone. Multi variety analysis shows synthetic steroid and periorbital triamcinolone has least association with SG. Macular oedema was more in SG which improved with low dose acetazolamide.25% cases had progressive visual field loss.
Conclusion: SG is an underappreciated visual threat in uveitis which can be modulated effectively with newer steroids and low dose acetazolamide.
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