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Secondary glaucoma in CAPN5-associated neovascular inflammatory vitreoretinopathy.

TitleSecondary glaucoma in CAPN5-associated neovascular inflammatory vitreoretinopathy.
Publication TypeJournal Article
Year of Publication2016
AuthorsCham, Abdourahman, Bansal Mayank, Banda Himanshu K., Kwon Young, Tlucek Paul S., Bassuk Alexander G., Tsang Stephen H., Sobol Warren M., Folk James C., Yeh Steven, and Mahajan Vinit B.
JournalClin Ophthalmol
Date Published2016

OBJECTIVE: The objective of this study was to review the treatment outcomes of patients with secondary glaucoma in cases of autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV), a hereditary autoimmune uveitis due to mutations in CAPN5.

PATIENTS AND METHODS: A retrospective, observational case series was assembled from ADNIV patients with secondary glaucoma. The main outcome measures were intraocular pressure (IOP), visual acuity, use of antiglaucoma medications, ocular surgeries, and adverse outcomes. Perimetry and optic disk optical coherence tomography (OCT) were also analyzed.

RESULTS: Nine eyes of five ADNIV patients with secondary glaucoma were reviewed. Each received a fluocinolone acetonide (FA) implant for the management of posterior uveitis. Following implantation, no eyes developed neovascular glaucoma. Five eyes (in patients 1, 2, and 5) required Ahmed glaucoma valve surgery for the management of steroid-responsive glaucoma. Patient 2 also developed angle closure with iris bombe and underwent laser peripheral iridotomy. Patient 4 had both hypotony and elevated IOP that required periodic antiglaucoma medication in the FA-implanted eye. Patient 3 did not develop steroid-response glaucoma in either eye. Optic disk examinations were obscured by fibrosis and better assessed with OCT.

CONCLUSION: ADNIV patients show combined mechanism secondary glaucoma best assessed by OCT of the optic disk. The FA implants have reduced uveitic and neovascular glaucoma. Nevertheless, IOP management remains complex due to steroid-response glaucoma, angle closure glaucoma, and hypotony.

Alternate JournalClin Ophthalmol
PubMed ID27390515
PubMed Central IDPMC4930228
Grant ListK08 EY020530 / EY / NEI NIH HHS / United States
R01 EY016822 / EY / NEI NIH HHS / United States