Influence of optic disc leakage on objective optic nerve head assessment in patients with uveitis.
PURPOSE
Secondary glaucoma is a common complication in patients with uveitis. Heidelberg Retina Tomography (HRT) and retinal nerve fiber layer (RNFL) thickness on optical coherence tomography (OCT) are widely used for examining optic nerve head changes. We evaluated these parameters in patients with uveitis and secondary glaucoma and with inflammatory papillary leakage on fluorescein angiography.


METHODS
Prospective single-center analysis of patients with uveitis, evaluating the impact of optic disc leakage on objective optic disc imaging parameters.


RESULTS
Overall, 96 eyes of 59 patients were included. Papillary leakage was found in 42 eyes (43.8 %), and secondary glaucoma was found in 41 eyes (42.7 %). Glaucoma and papillary leakage were present in 12 (29 %) eyes with leakage and in 29 (54 %) eyes without leakage (p = 0.023). Neuroretinal rim area (p = 0.004), rim volume on HRT (p = 0.004), and RNFL thickness on OCT (p = 0.0008) were significantly increased in eyes with papillary leakage, while RNFL on HRT was unchanged (p = 0.255). When only eyes with normal IOP were examined, all objective parameters on OCT and HRT were significantly increased, whereas in eyes with secondary glaucoma, there was only a trend in the same direction, which did not reach significance. A comparison of eyes with secondary glaucoma and optic disc leakage to normal eyes with no glaucoma or leakage revealed no difference in any of the parameters.


CONCLUSIONS
The objective parameters of optic nerve head imaging tools are significantly influenced by papillary leakage. In patients with secondary glaucoma and papillary leakage, these techniques are unable to detect and monitor glaucomatous damage.
['Heinz|Carsten|C|http://orcid.org/0000-0002-2814-4327', 'Kogelboom|Katy|K|', 'Heiligenhaus|Arnd|A|']
D000328:Adult D005260:Female D005451:Fluorescein Angiography D005902:Glaucoma, Open-Angle D006801:Humans D007429:Intraocular Pressure D008297:Male D008875:Middle Aged D009412:Nerve Fibers D009898:Optic Disk D010211:Papilledema D010539:Permeability D011446:Prospective Studies D012165:Retinal Ganglion Cells D041623:Tomography, Optical Coherence D014605:Uveitis
Uveitis Glaucoma Optical coherence tomography Optic disc edema