Therapeutic tendencies of uveitic glaucoma

Abstract

Introduction. Uveitic glaucoma, also known as inflammatory glaucoma, is a type of secondary glaucoma, one of the most serious complications of intraocular inflammation. It develops in uveitic eyes with increasing intraocular pressure (IOP) and affects the optic nerve, damaging it till blindness if left untreated. 20% of patients with chronic uveitis are at the onset point of glaucoma. As the incidence of uveitis is rising worldwide, the number of uveitic glaucoma is also increasing. Uveitic glaucoma treatment should be personalized for each patient,it aims at the administration of antiglaucomatous remedies, performing surgeries when indicated and applying new therapeutic trends. This article will be useful for the clinician to help a patient with inflammatory glaucoma. It aims to elucidate the key treatment aspects. Being a review article, it will be helpful for making a good therapeutic decision. It is our duty to preserve visual functions at the best possible level and improve patients' quality of life. Aim of study. Uveitic glaucoma leads to a drastic and irreversible decrease in visual acuity, to the invalidation of young, able to work patients. That is why the social impact of inflammatory glaucoma is considerable. Therapeutic approaches are varied and depend on the cause of eye inflammation, the most common being systemic diseases. In this case, interdisciplinary cooperation with fellow rheumatologists becomes imperative, they should prescribe all the necessary remedies to control systemic inflammation, and we as ophthalmologists will indicate antiglaucoma remedies and / or other necessary therapies. We will closely monitor the progress of the disease in order to keep as much as possible good visual functions of the patient. Methods and materials. We studied uveitic glaucoma in PubMed, NCBI and SCOPUS databases using keywords: inflammatory glaucoma, uveitic glaucoma, eye inflammation, uveitis. 78 articles were found. We studied 30 of them, which contained relevant information for achieving our goal. Results. The treatment of uveitic glaucoma is difficult, long way and strictly individualized process. It depends on the pathology that determines its appearance and development. The main directions of treatment are: treatment of the causative systemic disease, control of eye inflammation and antiglaucoma therapy. Systemic disease will be treated in collaboration with specialists, eye inflammation will be treated with anti-inflammatory remedies and glaucoma with antiglaucoma remedies. In about 25-30% of cases, antiglaucoma therapy fails and surgery will be needed such as: laser iridotomy, trabeculectomy, nonpenetrating glaucoma surgery, implantation of aqueous humor drainage devices, etc.. Recently, the medical community has shown interest in implementing biological therapy, and studies are being done in this direction. New therapeutic trends could have a favorable effect on the control of the glaucoma process in the eyes with uveitic glaucoma. Conclusion. Uveitic glaucoma can develop only in eye that has had a history of uveitis, and intraocular pressure must be increased. A specific and personalized approach, with the application of necessary therapy is the basis of an armed struggle against the disabling consequences of the disease.