Glaucoma in Patients with Scleritis
Heiligenhaus A.1, Dück N.1, Koch J.1, Hudde T.2
1Department of Ophthalmology at St. Franziskus Hospital, Muenster; 2Department of Ophthalmology, University of Duisburg-Essen
Purpose: Secondary glaucoma is a typical complication in patients with scleritis. Herein, the frequency of elevated intraocular pressure, type of glaucoma and course of disease was studied.
Method: Retrospective study of patients with scleritis (n=87) and episcleritis (n=18). The study parameters were: intraocular pressure (IOP), gonioscopic appearance, type of glaucoma, glaucomatous optic neuropathy, type of scleritis, uveitis or keratitis, activity of scleral inflammation, medical and surgical therapy, the course of disease and of vision.
Results: One patient with episcleritis (5.6%) had steroid-induced ocular hypertension. Twelve scleritis patients (13.8%) had elevated IOP (26-54 mmHg). Three had diffuse (of 39: 7.7%), 2 had nodular (of 27: 7.4%), 3 had necrotizing (of 10: 30%) and 4 had posterior scleritis (von 11: 36.4%). Elevated IOP was associated with flare-up of scleritis (n=10), uveitis (n=7) or peripheral ulcerative keratitis (PUK; n=4). Open-angle glaucoma (n=11) was more common than angle-closure glaucoma (n=1). By gonioscopy, anterior synechiae (n=6) and neovascularization (n=1) was found. Systemic antiinflammatory medication consisted of corticosteroids (n=8), MTX (n=7), cyclophosphamid (n=3) or nonsteroidal antiinflammatory drugs (n=4). Cyclo-photocoagulation was performed in 4
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