Cumulative Duration of Inflammatory Activity as a Risk Factor for Glaucoma/Hypertension in Vogt-Koyanagi-Harada Disease: A Case-Control Study in Argentina.
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Purpose
To estimate the association between the cumulative duration of inflammatory activity during follow-up of patients with Vogt-Koyanagi-Harada (VKH) and the development of glaucoma/hypertension
Methods
This is an observational, retrospective case-control study. Patients aged 18 or older diagnosed with VKH who visited a tertiary center in Argentina between 2018 and 2022.
Data were extracted from medical records of VKH patients, with cases and controls selected through convenience sampling.
Results
A total of 303 eyes from 152 VKH patients were analyzed. The median age was 37 years, with 124 female and 28 male. Glaucoma was observed in 106 eyes of 53 patients (35%), and ocular hypertension in 71 eyes (23.4%). A significant association was found between cumulative inflammatory duration and glaucoma development for durations of 12 months or more (OR 1.87, 95% CI 1.01–3.58, p=0.05). A reduced risk was observed for durations of 3 months or less (OR 0.23, 95% CI 0.15–0.35, p<0.00001) and 3 to 6 months (OR 0.49, 95% CI 0.28–0.82, p=0.0085). Early treatment initiation was associated with a reduced glaucoma risk, especially when started within one month of diagnosis (OR 0.40, 95% CI 0.28–0.56, p<0.00001) and initiating DMARD therapy within 3 months (OR 0.56, 95% CI 0.39–0.81, p=0.0024).
Conclusion
Cumulative duration of inflammatory activity is associated with the development of glaucoma. The focus should be on achieving early and sustained control of inflammation through immunosuppressive therapy to prevent this severely disabling complication
Conflict of interest
No
1
Last name
MONTOYA
Initials of first name(s)
J
Department
Uveitis section, ophthalmology department, Jose de San Martin clinic hospital
City
Buenos Aires
Country
Argentina
2
Last name
Couto
Initials of first name(s)
C
Department
Uveitis section, ophthalmology department, Jose de San Martin clinic hospital
City
Buenos Aires
Country
Argentina
3
Last name
Castro
Initials of first name(s)
G
Department
Center for Medical Education and Clinical Research CEMIC
City
Buenos Aires
Country
Argentina
4
Last name
Schlaen
Initials of first name(s)
A
Department
Uveitis section, ophthalmology department, Jose de San Martin clinic hospital
City
Buenos Aires
Country
Argentina
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