Recurrence of Inflammation With Prostaglandin Analogue Therapy in Uveitic Glaucoma
Purpose
A retrospective comparative case series to determine whether the use of prostaglandin analogue eye drops (PGA) to treat intraocular pressure (IOP) in patients with uveitic glaucoma is associated with a higher frequency of recurrent inflammation compared to eyes that are treated with non-PGA IOP lowering drops.
Methods
84 eyes (76 patients) with uveitic glaucoma treated at Kresge Eye Institute were identified. The following data was collected: date of disease onset, patient age at onset, race, IOP at diagnosis, number and type of IOP lowering drops initiated, use of systemic IOP lowering medication, systemic autoimmune disease associated with the uveitis, use of systemic immune suppression, and previous history of open angle glaucoma, diabetes mellitus and hypertension. 33 eyes were treated with prostaglandin analogues, 51 were treated with topical IOP-lowering agents other than PGA. The frequency and timing of recurrent uveitis in the PGA treated group and non-PGA treated group were compared.
Results
There was no significant difference in the frequency of recurrent uveitis in PGA-treated eyes compared to non-PGA-treated eyes for IOP control: 51% of eyes had at least one flare in the PGA-treated group compared to 45% of eyes in the non-PGA treated group (p=0.56, Fisher exact test). There was no significant difference in the mean time from onset of uveitic glaucoma to the first flare of uveitis in the two groups (11.5 months in non-PGA-treated vs. 13.5 months in PGA-treated, p=0.58). The mean IOP at initial diagnosis was significantly higher in the PGA-treated group compared to the non-PGA-treated group (35 vs. 30, p=0.02). The mean number of IOP lowering drops was higher in the PGA treated group compared to the non-PGA-treated group (3.5 vs. 2.4, respectively, p=0.03).
Conclusion
This study demonstrates that prostaglandin analogue drops are not associated with an increased frequency of recurrent inflammation in patients with uveitic glaucoma.