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Brimonidine-associated uveitis – a descriptive case series
BACKGROUND: Anterior uveitis secondary to topical brimonidine administration is rare and not well-defined. In glaucoma patients using brimonidine, one must consider this phenomenon to avoid mis-diagnosis and over-treatment with topical steroids which in turn may increase intraocular pressure (IOP)....
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745535/ https://www.ncbi.nlm.nih.gov/pubmed/33334316 http://dx.doi.org/10.1186/s12886-020-01762-w |
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author | Hopf, Susanne Mercieca, Karl Pfeiffer, Norbert Prokosch-Willing, Verena |
author_facet | Hopf, Susanne Mercieca, Karl Pfeiffer, Norbert Prokosch-Willing, Verena |
author_sort | Hopf, Susanne |
collection | PubMed |
description | BACKGROUND: Anterior uveitis secondary to topical brimonidine administration is rare and not well-defined. In glaucoma patients using brimonidine, one must consider this phenomenon to avoid mis-diagnosis and over-treatment with topical steroids which in turn may increase intraocular pressure (IOP). This is the largest case series including the longest patient follow-up in the current literature. METHODS: Sixteen patients (26 eyes) with consultant diagnosed brimonidine-associated anterior uveitis in a tertiary referral glaucoma clinic presenting between 2015 and 2019 were included in this retrospective case series. Clinical records were taken for descriptive analysis. Main outcome measures were the key clinical features, and disease course (therapy, IOP control, patient outcome). RESULTS: Key features were conjunctival ciliary injection and mutton fat keratic precipitation in all eyes. The findings were bilateral in 10 patients. Time between initiation of brimonidine treatment and presentation was 1 week to 49 months. Glaucoma sub-types were mostly pseudo-exfoliative and primary open angle glaucoma. Brimonidine treatment was stopped immediately. Additionally, topical corticosteroids were prescribed in 18 eyes and tapered down during the following 4 weeks. Thirteen eyes did not need surgical or laser treatment (median follow-up time 15 months). No patient showed recurrence of inflammation after cessation of brimonidine. CONCLUSIONS: This type of anterior uveitis is an uncommon but important manifestation which should always be considered in glaucoma patients on brimonidine treatment. Although treatable at its root cause, problems may persist, especially with respect to IOP control. The latter may necessitate glaucoma surgery after the resolved episode of the uveitis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12886-020-01762-w. |
format | Online Article Text |
id | pubmed-7745535 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-77455352020-12-18 Brimonidine-associated uveitis – a descriptive case series Hopf, Susanne Mercieca, Karl Pfeiffer, Norbert Prokosch-Willing, Verena BMC Ophthalmol Research Article BACKGROUND: Anterior uveitis secondary to topical brimonidine administration is rare and not well-defined. In glaucoma patients using brimonidine, one must consider this phenomenon to avoid mis-diagnosis and over-treatment with topical steroids which in turn may increase intraocular pressure (IOP). This is the largest case series including the longest patient follow-up in the current literature. METHODS: Sixteen patients (26 eyes) with consultant diagnosed brimonidine-associated anterior uveitis in a tertiary referral glaucoma clinic presenting between 2015 and 2019 were included in this retrospective case series. Clinical records were taken for descriptive analysis. Main outcome measures were the key clinical features, and disease course (therapy, IOP control, patient outcome). RESULTS: Key features were conjunctival ciliary injection and mutton fat keratic precipitation in all eyes. The findings were bilateral in 10 patients. Time between initiation of brimonidine treatment and presentation was 1 week to 49 months. Glaucoma sub-types were mostly pseudo-exfoliative and primary open angle glaucoma. Brimonidine treatment was stopped immediately. Additionally, topical corticosteroids were prescribed in 18 eyes and tapered down during the following 4 weeks. Thirteen eyes did not need surgical or laser treatment (median follow-up time 15 months). No patient showed recurrence of inflammation after cessation of brimonidine. CONCLUSIONS: This type of anterior uveitis is an uncommon but important manifestation which should always be considered in glaucoma patients on brimonidine treatment. Although treatable at its root cause, problems may persist, especially with respect to IOP control. The latter may necessitate glaucoma surgery after the resolved episode of the uveitis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12886-020-01762-w. BioMed Central 2020-12-17 /pmc/articles/PMC7745535/ /pubmed/33334316 http://dx.doi.org/10.1186/s12886-020-01762-w Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Hopf, Susanne Mercieca, Karl Pfeiffer, Norbert Prokosch-Willing, Verena Brimonidine-associated uveitis – a descriptive case series |
title | Brimonidine-associated uveitis – a descriptive case series |
title_full | Brimonidine-associated uveitis – a descriptive case series |
title_fullStr | Brimonidine-associated uveitis – a descriptive case series |
title_full_unstemmed | Brimonidine-associated uveitis – a descriptive case series |
title_short | Brimonidine-associated uveitis – a descriptive case series |
title_sort | brimonidine-associated uveitis – a descriptive case series |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7745535/ https://www.ncbi.nlm.nih.gov/pubmed/33334316 http://dx.doi.org/10.1186/s12886-020-01762-w |
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