Factors leading to high intraocular pressure in intraocular device-associated uveitis (IDAU): a nested case control study

Abstract

Purpose: To describe the clinical pattern of uveitis–glaucoma–hyphaema (UGH) syndrome and to evaluate the risk factors leading to high intraocular pressure among intraocular device-associated uveitis (IDAU) patients using the Chulalongkorn University Uveitis Cohort (CU2C) database. Methods: A retrospective nested case‒control study was conducted in a cohort of 375 subjects who were followed up in a uveitis clinic at King Chulalongkorn Memorial Hospital (KCMH), Bangkok, Thailand, from 2014 to 2022. Thirty subjects with IDAU with increased intraocular pressure (IOP) were included in the case group, and 60 subjects with IDAU without increased intraocular pressure were selected from the CU2C database as controls. By using univariate analysis and multivariate binary logistic regression analysis, the odds ratio (OR) and its 95% confidence interval (95% CI) were calculated between increasing IOP in IDAU subjects and other potential associated factors, including age, sex, comorbidities, long eye, myopia, vitrectomized eyes, ruptured posterior capsule, transillumination iris defect (TID), pseudophacodonesis, malpositioned IOL, and single-piece IOL in sulcus. Results: We retrospectively identified 90 patients who developed IDAU. Following a one-to-two case–control ratio, 30 case patients and 60 control patients were included. Three factors were significantly associated with high intraocular pressure in IDAU. These included intraocular lens (IOL) malposition (AOR: 8.30, 95% CI 1.25 to 54.76), long eye (AOR: 8.08, 95% CI 1.18 to 20.20) and age (AOR: 1.18, 95% CI 1.07 to 1.31). There was no statistical evidence of effects of hypertension, ruptured posterior capsule, vitrectomized eye, TID, pseudophacodonesis and single-piece IOL in sulcus on high IOP in IDAU. Conclusion: We demonstrated significant associations between various factors and high intraocular pressure in IDAU. Our findings provide useful information about potential risk factors to help physicians prevent and be aware of the progression of increasing IOP in IDAU.