Hypotony in patients with uveitis: The Multicenter Uveitis Steroid Treatment (MUST) Trial

Abstract

Purpose: To assess the prevalence of hypotony in patients with severe forms of uveitis.

Methods: The Multicenter Uveitis Steroid Treatment (MUST) Trial, a randomized study, enrolled 255 patients. Patients with hypotony at the baseline visit were identified.

Results: Twenty (8.3%) of 240 patients with sufficient data had hypotony. Hypotony was more common in patients with uveitis ≥5 years duration (odds ratio [OR] = 5.0; p < .01), and in eyes with a history of ocular surgery (vitrectomy vs. none, OR = 3.1; p = .03). Hypotony was less in patients with older age of uveitis onset (>51 years vs. <51 years, OR = 0.1; p = .02), in Caucasian patients (OR = 0.1; p < .01) compared to African American patients. Hypotonous eyes were more likely to have visual impairment (OR = 22.9; p < .01).

Conclusions: Hypotony is an important complication of uveitis and more commonly affects African-American patients, those with uveitis onset at a younger age, and those with longer disease duration. It is associated with visual impairment.

Trial registration: ClinicalTrials.gov NCT00132691.

Conflict of interest statement

Declaration of interest: Bausch & Lomb provided support to the study in the form of donationof a limited number of fluocinolone acetonide implants for patients randomized to implant therapy who were uninsured or otherwise unable to pay for implants, but did not otherwise support the study. Dr. Goldstein has served as a consultant to Bausch & Lomb. Dr. Drye reports no conflict of interest. Dr. Larson reports no conflict of interest. Dr. Sen reports no conflict of interest. Dr. Merrill has served as a consultant for Bausch & Lomb and Allergan Pharmaceutical Corporation. Dr. Pavan reports no conflict of interest. Dr. Sheppard has served as a consultant or Bausch & Lomb, Alcon Laboratories, Allergan Pharmaceutical Corporation, Lux Biosciences, and EyeGate Pharmaceuticals, and Inspire Pharmaceuticals. Ms. Burke reports no conflict of interest. Dr. Srivastava has served as a consultant for Bausch & Lomb, Alimera, Novartis Pharmaceuticals Corporation, and Allergan Pharmaceutical Corporation. Douglas A. Jabs, MD, MBA has acted as a consultant for Ciba Vision, Bayer Corporation, Novartis Pharmaceutical Corporation, Centocor, Inc., and SmithKline Beecham. Currently, Dr. Jabs is a consultant for Abbott Laboratories, Alcon Laboratories, Allergan Pharmaceutical Corporation, Corcept Therapeutics, GenenTech, Genzyme Corporation, GlaxoSmithKline, Novartis Pharmaceuticals Corporation, and Roche Pharmaceuticals. Research support has been provided from Roche Laboratories, Inc. in the past. Dr. Jabs currently acts as a Data and Safety Monitoring Board (DSMB) member for Applied Genetic Technologies Corporation (AGTC).