Uveitic glaucoma in a multi-ethnic Malaysian cohort: demography, risk factors and clinical outcomes

The association between uveitis and secondary glaucoma has been established, but the specific factors associated with progression to uveitic glaucoma remain poorly defined. This study aims to identify the prevalence and factors associated with uveitic glaucoma, and their clinical outcomes in a Malaysian cohort. Retrospective cohort study reviewing the clinical records of patients who attended the uveitis clinics at tertiary eye centres in Kuala Lumpur and Sarawak, Malaysia. A total of 257 eyes from 163 patients were included. Mean age at uveitis onset was 37.3 ± 16.2 years with a slight female predominance. The prevalence of uveitic ocular hypertension and uveitic glaucoma was 26.1% and 30.0% respectively. Multiple logistic regression identified age of onset (adjusted odds ratio [aOR] 1.023; 95% confidence interval [CI] 1.003–1.044, p = 0.023), male gender (aOR 1.970; 95% CI 1.046–3.709, p = 0.036), presence of posterior synechiae (PS) (aOR 3.326; 95% CI 1.092–10.133, p = 0.034), peripheral anterior synechiae (PAS) (aOR 4.606; 95% CI 2.065–10.272, p < 0.001) and intraocular pressure (IOP) at presentation (aOR 1.077; 95% CI 1.039–1.117, p < 0.001) as significant factors for uveitic glaucoma. Steroid responsiveness occurred in 74 (29.2%) corticosteroid-treated eyes. Fifty-three eyes (36.80%) required at least one glaucoma incisional surgery. Chronic uveitis ( p = 0.004) and PAS ( p < 0.001) were associated with a higher percentage of glaucoma surgery. Older age of onset, male gender, presence of PS or PAS, and elevated presenting IOP were significant factors associated with uveitic glaucoma. Additionally, chronic uveitis and PAS were factors associated with a higher percentage of glaucoma surgery. Early identification of these factors can prevent onset of uveitic glaucoma, which is a potential blinding complication of uveitis.