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Uveitic Glaucoma Interest Group Recommendations for Uveitis-Related Ocular Hypertension and Glaucoma Management
David S. Chu, MD
Presenter:
Mina B. Pantcheva, Sapna Gangaputra, Erin Sieck, Massimo Accorinti, Ron Neumann, Bryan Chin Hou Ang, Keith Barton, David S. Chu, John Grigg, John H. Kempen, Jeffrey M. Liebmann, Francisco J. Muñoz-Negrete, Quan Dong Nguyen, Alan G. Palestine, Jennifer Thorne, Charlotte van Meerwijk, Peizeng Yang, Marc D. de Smet
Authors:
Affiliation:
Mina B. Pantcheva: Sue Anschutz-Rodgers Eye Center, Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, USA
Sapna Gangaputra: Vanderbilt Eye Institute, Vanderbilt University, Nashville, Tennessee, USA
Erin Sieck: Department of Ophthalmology & Visual Sciences, Washington University, St. Louis, Missouri, USA
Massimo Accorinti: IRCCS Fondazione G.B. Bietti, Rome, Italy
Ron Neumann: Department of Ophthalmology, Maccabi Sherutei Briut, Ramat Hasharon, Israel
Bryan Chin Hou Ang: Department of Ophthalmology, Tan Tock Seng Hospital, National Healthcare Group Eye Institute, Singapore, Singapore; Department of Ophthalmology, Mayo Clinic, Jacksonville, Florida, USA
Keith Barton: Moorfields Eye Hospital, University College London, London, UK
David S. Chu: Metropolitan Eye Research and Surgery Institute, Palisades Park, New Jersey, USA; Institute of Ophthalmology and Visual Science, New Jersey Medical School, Rutgers University, New Brunswick, New Jersey, USA
John Grigg: Save Sight Institute, Sydney University, Sydney, Australia
John H. Kempen: Department of Ophthalmology, and Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA; Sight for Souls, Bellevue, Washington, USA; MCM Eye Unit, MyungSung Christian Medical Center (MCM) General Hospital and MyungSung Medical School, Addis Ababa, Ethiopia; Department of Ophthalmology, Addis Ababa University School of Medicine, Addis Ababa, Ethiopia
Jeffrey M. Liebmann: Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York, USA
Francisco J. Muñoz-Negrete: Hospital Universitario Ramon y Cajal, IRYCIS, Universidad Alcalá, Madrid, Spain
Quan Dong Nguyen: Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California, USA
Alan G. Palestine: Department of Ophthalmology, University of Colorado, Aurora, Colorado, USA
Jennifer Thorne: Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; The Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Charlotte van Meerwijk: Department of Ophthalmology, University Medical Center Groningen, Groningen, the Netherlands
Peizeng Yang: Department of Ophthalmology, The 1st Affiliated Hospital of Chongqing Medical University, Chongqing, China
Marc D. de Smet: Microinvasive Ocular Surgery Institute, Lausanne, Switzerland; New York Eye and Ear Institute of Mt Sinai, Icahn School of Medicine, New York, USA; Department Ophthalmology, Université libre de Bruxelles, Brussels, Belgium
Purpose: The Uveitic Glaucoma Interest Group (UGIG) proposes guidelines aimed at reducing practice variability through best practice management guidelines for uveitis-related ocular hypertension (UOHT) and uveitic glaucoma (UG).
Methods: A group of ophthalmologists with expertise in uveitis and glaucoma performed an extensive review of the literature pertaining to UOHT and UG. Findings from this review informed the working group discussions, through which consensus recommendations were made to standardize best management practices.
Results: The recommendations outline key components of glaucoma-related testing and timing along with a proposed follow-up schedule for uveitis patients. These include recommendations for intraocular pressure (IOP) monitoring and goals, follow-up after initiation of corticosteroids or IOP-lowering agents, timing of referral to a glaucoma specialist, and detailed management considerations. Consistently maintaining IOP below 16 mmHg was identified as a marker of protection against progression toward UG.
Conclusions: The UGIG proposes recommendations to standardize care for patients with UG and improve clinical outcomes. A consensus is presented regarding IOP management based on a more stringent IOP threshold of 16 mmHg. Close collaboration between uveitis and glaucoma specialists is encouraged, with early referral, ideally at the initiation of IOP-lowering therapy.
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