Risk factors for secondary glaucoma in children

For children with uveitis, juvenile idiopathic arthritis-associated uveitis and ANA-positive uveitis without evidence of arthritis are the most common risk factors for developing secondary glaucoma, according to the results of a study published in the May 2006 issue of Ophthalmology.

Karen M. Sijssens MD, and her colleagues from the FC Donders Institute of Ophthalmology, Utrecht, and the University Eye Clinic, Maastricht, The Netherlands, conducted a retrospective, observational case series of 256 eyes of 147 children diagnosed with uveitis before the age of 16.

The researchers were looking for localization and course of uveitis, underlying systemic disease, onset of ocular hypertension, onset of secondary glaucoma, treatment with steroids, antinuclear antibodies (ANAs), lens extractions, number of blind eyes at onset and during follow-up.

Elevated intraocular pressure (IOP) was recorded in 35% of subjects regardless of the form or type of uveitis. However, secondary glaucoma developed more frequently (38%) in juvenile idiopathic arthritis-associated uveitis compared with other forms of uveitis (11%). Secondary glaucoma was also observed more frequently in subjects who were ANA positive (42%) than those who were ANA negative (6%). Except for patients with juvenile idiopathic arthritis-associated uveitis, periocular steroid injections represented an additional risk factor for secondary glaucoma, limited to the early phases of the disease process.

The results suggest a strong link between juvenile idiopathic arthritis-associated uveitis, ANA-positive uveitis and secondary glaucoma.