Glaucoma in Uveitis

  • Sharanya Abraham
  • Ronnie George


The sight-threatening complications of uveitis include damage to the retina and glaucoma. Elevated intraocular pressure (IOP) is an important secondary complication that may result from ocular inflammatory sequelae or as a side effect of corticosteroids used to treat the inflammation [1].


Juvenile Idiopathic Arthritis Trabecular Meshwork Triamcinolone Acetonide Selective Laser Trabeculoplasty Fluocinolone Acetonide 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Siddique S, Suelves A, Baheti U, et al. Glaucoma and uveitis. Surv Ophthalmol. 2013;58:1–10.CrossRefPubMedGoogle Scholar
  2. 2.
    Heinz C, Koch JM, Zurek-Imhoff B, et al. Prevalence of uveitic secondary glaucoma and success of nonsurgical treatment in adults and children in a tertiary referral center. Ocul Immunol Inflamm. 2009;17:243–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Sijssens KM, Rothova A, Berendschot TT, et al. Ocular hypertension and secondary glaucoma in children with uveitis. Ophthalmology. 2006;113:853–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Moorthy RS, Mermoud A, Baerveldt G, et al. Glaucoma associated with uveitis. Surv Ophthalmol. 1997;41:361–94.CrossRefPubMedGoogle Scholar
  5. 5.
    Herbert HM, Viswanathan A, Jackson H, et al. Risk factors for elevated intraocular pressure in uveitis. J Glaucoma. 2004;13:96–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Neri P, Azuara-Blanco A, Forrester JV. Incidence of glaucoma in patients with uveitis. J Glaucoma. 2004;13:461–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Sallam A, Sheth HG, Habot-Wilner Z, et al. Outcome of raised intraocular pressure in uveitic eyes with and without a corticosteroid-induced hypertensive response. Am J Ophthalmol. 2009;148:207–13.CrossRefPubMedGoogle Scholar
  8. 8.
    Kishi A, Nao-i N, Sawada A. Ultrasound biomicroscopic findings of acute angle-closure glaucoma in Vogt-Koyanagi-Harada syndrome. Am J Ophthalmol. 1996;122:735–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Hirose S, Ohno S, Matsuda H. HLA-Bw54 and glaucomatocyclitic crisis. Arch Ophthalmol. 1985;103:1837–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Liesegang TJ. Clinical features and prognosis in Fuchs uveitis syndrome. Arch Ophthalmol. 1982;100:1622–6.CrossRefPubMedGoogle Scholar
  11. 11.
    Raitta C, Vannas A. Glaucomatocyclitic crisis. Arch Ophthalmol. 1977;95:608–12.CrossRefPubMedGoogle Scholar
  12. 12.
    Yamamoto S, Pavan-Langston D, Tada R, et al. Possible role of herpes simplex virus in the origin of Posner Schlossman syndrome. Am J Ophthalmol. 1995;119:796–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Knox DL. Glaucomatocyclitic crises and systemic disease: peptic ulcer, other gastrointestinal disorders, allergy and stress. Trans Am Ophthalmol Soc. 1988;86:473–95.PubMedCentralPubMedGoogle Scholar
  14. 14.
    Hung PT, Chang JM. Treatment of glaucomatocyclitic crises. Am J Ophthalmol. 1974;77:169–72.CrossRefPubMedGoogle Scholar
  15. 15.
    Kanski JJ, Shun-Shin GA. Systemic uveitis syndromes in childhood: an analysis of 340 cases. Ophthalmology. 1984;91:1247–52.CrossRefPubMedGoogle Scholar
  16. 16.
    Ho CL, Wong EYM, Walton DS. Goniosurgery for glaucoma complicating chronic childhood uveitis. Arch Ophthalmol. 2004;122(6):838–44.CrossRefPubMedGoogle Scholar
  17. 17.
    Da Mata A, Burk SE, Netland PA, Baltazis S, Christen WB, Foster CS. Management of uveitic glaucoma with Ahmed glaucoma valve implantation. Ophthalmology. 1999;106(11):2168–72.CrossRefPubMedGoogle Scholar
  18. 18.
    Ozdal PC, Vianna RNG, Deschenes J. Ahmed valve implantation in glaucoma secondary to chronic uveitis. Eye (Lond). 2006;20(2):178–83.CrossRefGoogle Scholar
  19. 19.
    Papadaki TG, Zacharopoulos JP, Pasquale LR, Christen WB, Netland PA, Foster CS. Long-term results of Ahmed glaucoma valve implantation for uveitic glaucoma. Am J Ophthalmol. 2007;144(1):62–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Rolim de Moura C, Fraser-Bell S, Stout A, Labree L, Nilfours M, Varma R. Experience with the Baerveldt glaucoma implant in the management of pediatric glaucoma. Am J Ophthalmol. 2005;139(5):847–54.CrossRefPubMedGoogle Scholar
  21. 21.
    Kafkala C, Hynes A, Choi J, Topalkara A, Foster CS. Ahmed valve implantation for uncontrolled pediatric uveitic glaucoma. J AAPOS. 2005;9(4):336–40.CrossRefPubMedGoogle Scholar
  22. 22.
    O’Malley Schotthoefer E, Yanovitch TL, Freedman SF. Aqueous drainage device surgery in refractory pediatric glaucomas: I. Long-term outcomes. J AAPOS. 2008;12(1):33–9.CrossRefPubMedGoogle Scholar
  23. 23.
    O’Malley Schotthoefer E, Yanovitch TL, Freedman SF. Aqueous drainage device surgery in refractory pediatric glaucoma: II. Ocular motility consequences. J AAPOS. 2008;12(1):40–5.CrossRefPubMedGoogle Scholar
  24. 24.
    Bohnsack BL, Freedman SF. Surgical outcomes in childhood uveitic glaucoma. Am J Ophthalmol. 2013;155:134–42.CrossRefPubMedGoogle Scholar
  25. 25.
    Miserocchi E, Waheed NK, Dios E, et al. Visual outcome in herpes simplex virus and varicella zoster virus uveitis: a clinical evaluation and comparison. Ophthalmology. 2002;109:1532–7.CrossRefPubMedGoogle Scholar
  26. 26.
    Karbassi M, Raizman MB, Schuman JS. Herpes zoster ophthalmicus. Surv Ophthalmol. 1992;36:395–410.CrossRefPubMedGoogle Scholar
  27. 27.
    Friedman D, Holbrook J, Ansari H, et al. Risk of elevated intraocular pressure and glaucoma in patients with uveitis: results of the multicenter uveitis steroid treatment trial. Ophthalmology. 2013;120:1571–9.PubMedCentralCrossRefPubMedGoogle Scholar
  28. 28.
    Falcon MG, Williams HP. Herpes simplex keratouveitis and glaucoma. Trans Ophthalmol Soc UK. 1978;98:101–4.PubMedGoogle Scholar
  29. 29.
    Gupta K, Hoepner J, Streeten B. Pseudomelanoma of the iris in herpes simplex keratouveitis. Ophthalmology. 1986;93:1524–7.CrossRefPubMedGoogle Scholar
  30. 30.
    Liesegang TJ. Classification of herpes simplex virus keratitis and anterior uveitis. Cornea. 1999;18:127–43.CrossRefPubMedGoogle Scholar
  31. 31.
    Tiwari V, Clement C, Scanlan P, et al. A role for herpesvirus entry mediator as the receptor for herpes simplex virus1 entry into primary human trabecular meshwork cells. J Virol. 2005;79:13173–9.PubMedCentralCrossRefPubMedGoogle Scholar
  32. 32.
    The Herpetic Eye Disease Study Group. Acyclovir for the prevention of recurrent herpes simplex virus eye disease. N Engl J Med. 1998;339:300–6.CrossRefGoogle Scholar
  33. 33.
    Uchoa UB, Rezende RA, Carrasco MA, et al. Long-term acyclovir use to prevent recurrent ocular herpes simplex virus infection. Arch Ophthalmol. 2003;121:1702–4.CrossRefPubMedGoogle Scholar
  34. 34.
    Clark AF, Wilson K, McCartney MD, Miggans ST, Kunkle M, Howe W. Glucocorticoid-induced formation of cross-linked actin networks in cultured human trabecular meshwork cells. Invest Ophthalmol Vis Sci. 1994;35:281–94.PubMedGoogle Scholar
  35. 35.
    Kersey JP, Broadway DC. Corticosteroid-induced glaucoma: a review of the literature. Eye. 2006;20:407–16.CrossRefPubMedGoogle Scholar
  36. 36.
    Zhang X, Ognibene CM, Clark AF, et al. Dexamethasone inhibition of trabecular meshwork cell phagocytosis and its modulation by glucocorticoid receptor beta. Exp Eye Res. 2007;84:275–84.PubMedCentralCrossRefPubMedGoogle Scholar
  37. 37.
    Singh IP, Ahmad SI, Yeh D, et al. Early rapid rise in intraocular pressure after intravitreal triamcinolone acetonide injection. Am J Ophthalmol. 2004;138:286–7.CrossRefPubMedGoogle Scholar
  38. 38.
    Underwood JL, Murphy CG, Chen J, et al. Glucocorticoids regulate transendothelial fluid flow resistance and formation of intercellular junctions. Am J Physiol. 1999;277:330–42.Google Scholar
  39. 39.
    Benz MS, Albini TA, Holz ER, et al. Short-term course of intraocular pressure after intravitreal injection of triamcinolone acetonide. Ophthalmology. 2006;113:1174–8.CrossRefPubMedGoogle Scholar
  40. 40.
    Moshfeghi AA, Scott IU, Flynn Jr HW, et al. Pseudohypopyon after intravitreal triamcinolone acetonide injection for cystoids macular edema. Am J Ophthalmol. 2004;138:489–92.CrossRefPubMedGoogle Scholar
  41. 41.
    Ruiz-Moreno JM, Montero JA, Artola A, et al. Anterior chamber transit of triamcinolone after intravitreal injection. Arch Ophthalmol. 2005;123:129–30.CrossRefPubMedGoogle Scholar
  42. 42.
    Edelhauser HF, Rowe-Rendleman CL, Robinson MR, et al. Ophthalmic drug delivery systems for the treatment of retinal disease: basic research to clinical applications. Invest Ophthalmol Vis Sci. 2010;51:5403–20.PubMedCentralCrossRefPubMedGoogle Scholar
  43. 43.
    Dada T, Dhawan M, Garg S, et al. Safety and efficacy of intraoperative intravitreal injection of triamcinolone acetonide injection after phacoemulsification in cases of uveitic cataract. J Cataract Refract Surg. 2007;33:1613–8.CrossRefPubMedGoogle Scholar
  44. 44.
    Im L, Allingham RR, Singh I, et al. A prospective study of early intraocular pressure changes after a single intravitreal triamcinolone injection. J Glaucoma. 2008;17:128–32.CrossRefPubMedGoogle Scholar
  45. 45.
    Lang Y, Leibu R, Shoham N, et al. Evaluation of intravitreal kenalog toxicity in humans. Ophthalmology. 2007;114:724–31.CrossRefPubMedGoogle Scholar
  46. 46.
    Rhee DJ, Peck RE, Belmont J, et al. Intraocular pressure alterations following intravitreal triamcinolone acetonide. Br J Ophthalmol. 2006;90:999–1003.PubMedCentralCrossRefPubMedGoogle Scholar
  47. 47.
    Campochiaro PA, Hafiz G, Shah SM, et al. Sustained ocular delivery of fluocinolone acetonide by an intravitreal insert. Ophthalmology. 2010;117:1393–9.CrossRefPubMedGoogle Scholar
  48. 48.
    Jaffe GJ, Martin D, Callanan D, et al. Fluocinolone acetonide implant (Retisert) for noninfectious posterior uveitis: thirty-four-week results of a multicenter randomized clinical study. Ophthalmology. 2006;113:1020–7.CrossRefPubMedGoogle Scholar
  49. 49.
    Kiddee W, Trope G, Sheng L, et al. Intraocular pressure monitoring post intravitreal steroids: a systematic review. Surv Ophthalmol. 2013;58:291–310.CrossRefPubMedGoogle Scholar
  50. 50.
    Jonas JB, Kreissig I, Degenring RF. Intraocular pressure after intravitreal injection of triamcinolone acetonide. Br J Ophthalmol. 2003;87:24–7.PubMedCentralCrossRefPubMedGoogle Scholar
  51. 51.
    Shukla D, Vidhya N, Prasad NM, et al. Evaluation of patient age as a risk factor for intraocular pressure elevation after intravitreal triamcinolone. Am J Ophthalmol. 2007;144:453–4.CrossRefPubMedGoogle Scholar
  52. 52.
    Roth DB, Verma V, Realini T, et al. Long-term incidence and timing of intraocular hypertension after intravitreal triamcinolone acetonide injection. Ophthalmology. 2009;116:455–60.CrossRefPubMedGoogle Scholar
  53. 53.
    Galor A, Margolis R, Brasil OM, et al. Adverse events after intravitreal triamcinolone in patients with and without uveitis. Ophthalmology. 2007;114:1912–8.CrossRefPubMedGoogle Scholar
  54. 54.
    Jonas JB, Schlichtenbrede F. Visual acuity and intraocular pressure after high-dose intravitreal triamcinolone acetonide in selected ocular diseases. Eye. 2008;22:869–73.CrossRefPubMedGoogle Scholar
  55. 55.
    Multicenter Uveitis Steroid Treatment Trial Research Group. The Multicenter Uveitis Steroid Treatment Trial: rationale, design and baseline characteristics. Am J Ophthalmol. 2010;149:550–61.CrossRefGoogle Scholar
  56. 56.
    Multicenter Uveitis Steroid Treatment (MUST) Trial Research Group, Kempen JH, Altaweel MM, Holbrook JT, et al. Randomized comparison of systemic anti-inflammatory therapy versus fluocinolone acetonide implant for intermediate, posterior and panuveitis: the Multicenter Uveitis Treatment Trial. Ophthalmology. 2011;118:1916–26.CrossRefGoogle Scholar
  57. 57.
    Sung VC, Barton K. Management of inflammatory glaucomas. Curr Opin Ophthalmol. 2004;15:136–40.CrossRefPubMedGoogle Scholar
  58. 58.
    Kuchtey RW, Lowder CY, Smith SD. Glaucoma in patients with ocular inflammatory disease. Ophthalmol Clin North Am. 2005;18:421–30, vii.CrossRefPubMedGoogle Scholar
  59. 59.
    Chang JH, McCluskey P, Missotten T, et al. Use of ocular hypotensive prostaglandin analogues in patients with uveitis: does their use increase anterior uveitis and cystoid macular oedema? Br J Ophthalmol. 2008;92:916–21.CrossRefPubMedGoogle Scholar
  60. 60.
    Borisuth NS, Phillips B, Krupin T. The risk profile of glaucoma filtration surgery. Curr Opin Ophthalmol. 1999;10:112–6.CrossRefPubMedGoogle Scholar
  61. 61.
    Noble J, Derzko-Dzulynsky L, Rabinovitch T, Birt C. Outcome of trabeculectomy with intraoperative mitomycin C for uveitic glaucoma. Can J Ophthalmol. 2007;42:89–94.CrossRefPubMedGoogle Scholar
  62. 62.
    Mac I, Soltau JB. Glaucoma-filtering bleb infections. Curr Opin Ophthalmol. 2003;14:91–4.CrossRefPubMedGoogle Scholar
  63. 63.
    Iwao K, Inatani M, Seto T, et al. Long-term outcomes and prognostic factors for trabeculectomy with mitomycin C in eyes with uveitic glaucoma: a retrospective cohort study. J Glaucoma. 2012;00:1–7.Google Scholar
  64. 64.
    Towler HM, McCluskey P, Shaer B, et al. Long-term follow-up of trabeculectomy with intraoperative 5-fluorouracil for uveitis-related glaucoma. Ophthalmology. 2000;107:1822–8.CrossRefPubMedGoogle Scholar
  65. 65.
    Patitsas CJ, Rockwood EJ, Meisler DM, et al. Glaucoma filtering surgery with postoperative 5-fluorouracil in patients with intraocular inflammatory disease. Ophthalmology. 1992;99:594–9.CrossRefPubMedGoogle Scholar
  66. 66.
    Kaburaki T, Koshino T, Kawashima H, et al. Initial trabeculectomy with mitomycin C in eyes with uveitic glaucoma with inactive uveitis. Eye (Lond). 2009;23:1509–17.CrossRefGoogle Scholar
  67. 67.
    Chawla A, Mercieca K, Fenerty C, et al. Outcomes and complications of trabeculectomy enhanced with 5-fluorouracil in adults with glaucoma secondary to uveitis. J Glaucoma. 2012;00:7–10.Google Scholar
  68. 68.
    Ang GS, Varga Z, Shaarawy T. Postoperative infection in penetrating versus non-penetrating glaucoma surgery. Br J Ophthalmol. 2010;94:1571–6.CrossRefPubMedGoogle Scholar
  69. 69.
    Dupas B, Fardeau C, Cassoux N, et al. Deep sclerectomy and trabeculectomy in uveitic glaucoma. Eye (Lond). 2010;24:310–4.CrossRefGoogle Scholar
  70. 70.
    Mendrinos E, Mermoud A, Shaarawy T. Nonpenetrating glaucoma surgery. Surv Ophthalmol. 2008;53:592–630.CrossRefPubMedGoogle Scholar
  71. 71.
    Nguyen QH, Budenz DL, Parrish 2nd RK. Complications of Baerveldt glaucoma drainage implants. Arch Ophthalmol. 1998;116:571–5.CrossRefPubMedGoogle Scholar
  72. 72.
    Nguyen QH. Avoiding and managing complications of glaucoma drainage implants. Curr Opin Ophthalmol. 2004;15:147–50.CrossRefPubMedGoogle Scholar
  73. 73.
    Schwartz KS, Lee RK, Gedde SJ. Glaucoma drainage implants: a critical comparison of types. Curr Opin Ophthalmol. 2006;17:181–9.CrossRefPubMedGoogle Scholar
  74. 74.
    Schwartz KS, Lee RK, Gedde SJ. Long-term results of Ahmed glaucoma valve implantation for uveitic glaucoma. Am J Ophthalmol. 2007;144:62–9.CrossRefGoogle Scholar
  75. 75.
    Kalinina Ayuso V, Scheerlinck L, de Boer J, et al. The effect of an Ahmed glaucoma valve implant on corneal endothelial cell density in children with glaucoma secondary to uveitis. Am J Ophthalmol. 2013;155:530–5.CrossRefPubMedGoogle Scholar
  76. 76.
    Malone P, Herndon L, Muir K, et al. Combined fluocinolone acetonide intravitreal insertion and glaucoma drainage device placement for chronic uveitis and glaucoma. Am J Ophthalmol. 2010;149:800–6.e1.CrossRefPubMedGoogle Scholar
  77. 77.
    Vernon SA, Koppens JM, Menon GJ, et al. Diode laser cycloablation in adult glaucoma: long-term results of a standard protocol and review of current literature. Clin Experiment Ophthalmol. 2006;34:411–20.CrossRefPubMedGoogle Scholar
  78. 78.
    Vasconcelos-Santos DV, Nehemy PG, Schachat AP, et al. Secondary ocular hypertension after intravitreal injection of 4 mg of triamcinolone acetonide: incidence and risk factors. Retina. 2008;28:573–80.CrossRefPubMedGoogle Scholar
  79. 79.
    Bollinger K, Smith S. Prevalence and management of elevated intraocular pressure after placement of an intravitreal sustained-release steroid implant. Curr Opin Ophthalmol. 2009;20:99–103.CrossRefPubMedGoogle Scholar

Copyright information

© Springer India 2016

Authors and Affiliations

  • Sharanya Abraham
    • 1
  • Ronnie George
    • 2
  1. 1.Department of Uvea and Medical RetinaSankara NethralayaChennaiIndia
  2. 2.Senior Consultant, Smt Jadhavbai Nathmal Singhvee, Department of Glaucoma ServicesMedical Research Foundation, Sankara NethralayaChennaiIndia

Personalised recommendations