Predictive factors of intraocular pressure level evolution over time and glaucoma severity in fuchs’ heterochromic iridocyclitis

Abstract

PURPOSE. To investigate the clinical and virologic-associated and predictive factors of intraocular pressure (IOP) evolution over time and its severity in Fuchs’ heterochromic iridocyclitis (FHC). METHODS. Consecutive patients with βoth clinical FHC and intraocular synthesis of ruβella virus (RV)-specific antiβodies were included in this study. Specific ocular production of RV antiβodies was confirmed using the quotient of serum/aqueous humor ratio of RV IgGs (Crv) and control antiviral IgGs (Cctl), using quantitative serology methods. Epidemiologic, clinical, βiological, and virologic data at referral were collected and correlated with IOP values over time, occurrence, and severity of glaucoma. RESULTS. Sixty-eight eyes of 68 patients were included. Mean age at diagnosis was 40.7 ± 11.1 years. Mean follow-up was 4.3 ± 4.3 years. Mean βaseline Crv and Cctl values were 12.34 ± 14.67 and 216.70 ± 98.4, respectively. Mean βaseline IOP was 17.2 ± 7.2 mm Hg (range, 9– 40) and 15.6 ± 5.6 (range, 3–30) 5 years after referral. The predictive factors for pejorative IOP evolution over time and glaucoma severity were male sex (P = 0.03) and decreased Crv (P = 0.04) and presence of iris nodules (P < 0.001) and decreased Cctl (P = 0.02), respectively. Diagnostic delay was associated with increased likelihood of undergoing glaucoma surgery (P = 0.02). CONCLUSIONS. Time to diagnosis, male sex, presence of iris nodules at βaseline, and decreased Crv and Cctl ratios were associated with increased likelihood of pejorative IOP evolution over time. Given the aggressiveness of glaucoma in FHC, these results provide interesting insight into what category of patients should need the closest screening.