ISSN: 1300-0365
Dil: Türkçe
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Uveitic Glaucomas
Dr. Şansal GEDİK,a Dr. Yonca A. AKOVA,a Dr. Aysun ŞANAL DO-ĞANa
aGöz Hastalıkları AD, Başkent Üniversitesi Tıp Fakültesi, ANKARA
Uveitis, having an immunologic origin, is the inflammation of uveal tissue. In different type of uveitis, the intraocular pressure may be in normal levels or decreased, but glaucoma must always be considered as a risk. In uveitis,T lymphocytes induce accumulation of the polymorphonuclear leukocytes and macrophages which prevent the aqueous drainage. Intraocular pressure increases as a result of the effects of cytokines, free radicals and arachidonic acid metabolites on endothelial cells of trabecular system. This increase of the intraocular pressure may also be the main side effect of corticosteroids, which are the primary choice in treatment of uveitis.
To suppress the inflammation is necessary in treatment of uveitic glaucomas. The aim of the therapy is to prevent the permanent structural alterations in the site of angle and optical injury. In order to plan the therapy of uveitis, the etiology of the uveitis must be outlined and the probable pathological changes must be taken into consideration. Beta-blockers, adrenergic system agonists and carbonic anhydrase inhibitors are the ones, which preferred in the therapy. The hyperosmotic agents may also be used in acute attacks for a short time period. Laser iridotomy, iridectomy, trabeculectomy, seton surgery and cyclodestructive therapy like diode laser cyclophotocoagualtion can be used in cases, which medical therapy is not adequate. Inflammation must be controlled for at least three months before the filtrating surgery. Treatment may be more difficult in cases with uveitic glaucomas, which has been formed because of steroids. In these patients immunosuppressive agents can be used and in addition antifibrotic agents can raise the chance of success.Keywords: Uveitis, glaucomaTurkiye Klinikleri J Ophthalmol 2005, 14:130-136
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