American journal of ophthalmology · 2026
Risk of Glaucoma in Patients With Idiopathic Noninfectious Uveitis: A Multi-Institutional Real-World Retrospective Cohort Study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Liu De-Yi, Kuo Hou-Ting, Hsu Alan Y, Lin Chun-Ju, Shao Yi-Ching, Chen Huan-Sheng, Chiang Chun-Chi, Hsia Ning-Yi, Lai Chun-Ting, Wang Yu-Hsun, Wei James Cheng-Chung, Tsai Yi-Yu
Аннотация
OBJECTIVE: To determine the risk of developing glaucoma following a diagnosis of idiopathic noninfectious uveitis and to stratify this risk by uveitis subtype, patient demographics, and corticosteroid use.
DESIGN: Retrospective cohort study using data from January 1, 2006, to December 31, 2024.
PARTICIPANTS: Adult patients with noninfectious uveitis were identified within a multi-institutional US collaborative federated research network. Patients with systemic autoimmune diseases were excluded to isolate ocular inflammation risk. After 1:1 propensity score matching for age, sex, race, comorbidities, and medication use, two balanced cohorts of 16,910 patients each were established.
METHOD: The exposure was a diagnosis of noninfectious uveitis. Patients were followed for the development of new glaucoma diagnoses, identified using ICD-10-CM codes. A sensitivity analysis using an ophthalmology encounters control group was performed to address potential surveillance bias.
MAIN OUTCOME MEASURES: The primary outcome was the incidence of a new glaucoma diagnosis after the index date, identified by ICD-10-CM codes.
RESULTS: Patients with noninfectious uveitis had a nearly 10-fold increased risk of developing glaucoma compared to controls (hazard ratio [HR], 9.63; 95% CI, 7.75-11.95). This risk remained robust in the sensitivity analysis (HR, 7.11; 95% CI, 6.21-8.15). The risk was highest during the first follow-up year (HR, 33.78; 95% CI, 19.02-59.90), and was significant across most subtypes, including primary open-angle glaucoma (HR, 4.47; 95% CI, 3.50-5.69), primary angle-closure glaucoma (HR, 11.55; 95% CI, 5.60-23.82), and drug-induced glaucoma (HR, 51.29; 95% CI, 16.35-160.00). Among uveitis subtypes, panuveitis was associated with the greatest risk (HR, 50.49; 95% CI, 22.36-113.00). Stratified analyses showed a markedly elevated uveitis risk for glaucoma in the youngest age group (18-49 years: HR, 36.65; 95% CI, 18.14-74.00). Both systemic (HR, 10.19; 95% CI, 6.34-16.37) and ophthalmic (HR, 5.67; 95% CI, 3.88-8.30) corticosteroid use were associated with increased uveitis risk for glaucoma.
CONCLUSIONS: Noninfectious uveitis is a significant risk factor for glaucoma, with the highest risk observed in younger adults, panuveitis patients, and during the first year after diagnosis. These findings underscore the need for a risk-stratified glaucoma surveillance to prevent irreversible vision loss.
DESIGN: Retrospective cohort study using data from January 1, 2006, to December 31, 2024.
PARTICIPANTS: Adult patients with noninfectious uveitis were identified within a multi-institutional US collaborative federated research network. Patients with systemic autoimmune diseases were excluded to isolate ocular inflammation risk. After 1:1 propensity score matching for age, sex, race, comorbidities, and medication use, two balanced cohorts of 16,910 patients each were established.
METHOD: The exposure was a diagnosis of noninfectious uveitis. Patients were followed for the development of new glaucoma diagnoses, identified using ICD-10-CM codes. A sensitivity analysis using an ophthalmology encounters control group was performed to address potential surveillance bias.
MAIN OUTCOME MEASURES: The primary outcome was the incidence of a new glaucoma diagnosis after the index date, identified by ICD-10-CM codes.
RESULTS: Patients with noninfectious uveitis had a nearly 10-fold increased risk of developing glaucoma compared to controls (hazard ratio [HR], 9.63; 95% CI, 7.75-11.95). This risk remained robust in the sensitivity analysis (HR, 7.11; 95% CI, 6.21-8.15). The risk was highest during the first follow-up year (HR, 33.78; 95% CI, 19.02-59.90), and was significant across most subtypes, including primary open-angle glaucoma (HR, 4.47; 95% CI, 3.50-5.69), primary angle-closure glaucoma (HR, 11.55; 95% CI, 5.60-23.82), and drug-induced glaucoma (HR, 51.29; 95% CI, 16.35-160.00). Among uveitis subtypes, panuveitis was associated with the greatest risk (HR, 50.49; 95% CI, 22.36-113.00). Stratified analyses showed a markedly elevated uveitis risk for glaucoma in the youngest age group (18-49 years: HR, 36.65; 95% CI, 18.14-74.00). Both systemic (HR, 10.19; 95% CI, 6.34-16.37) and ophthalmic (HR, 5.67; 95% CI, 3.88-8.30) corticosteroid use were associated with increased uveitis risk for glaucoma.
CONCLUSIONS: Noninfectious uveitis is a significant risk factor for glaucoma, with the highest risk observed in younger adults, panuveitis patients, and during the first year after diagnosis. These findings underscore the need for a risk-stratified glaucoma surveillance to prevent irreversible vision loss.