Prevalence of ocular hypertension and glaucoma in patients with chronic ocular graft-versus-host disease

Abstract

Purpose To evaluate the prevalence of ocular hypertension (OHT) and glaucoma in patients with chronic ocular graft-versus-host disease (GVHD). Methods We performed a retrospective chart review of 218 patients diagnosed with chronic ocular GVHD. Ocular hypertension was defined as intraocular pressure (IOP) ≥ 24 mm Hg in either eye without any glaucomatous optic disc changes. Glaucoma suspect was defined as optic disc changes with a cup-disc ratio ≥ 0.7 in either eye or asymmetry of ≥ 0.3 between the two eyes. Glaucoma was defined by glaucomatous optic disc changes plus glaucomatous visual field defects in two consecutive reliable visual field tests. Number of cases of ocular hypertension, glaucoma, and glaucoma suspects was evaluated. Results Thirty-three patients (15%) were diagnosed with OHT, eight patients (3.6%) with suspicion of glaucoma, and one patient (0.4%) with glaucoma. OHT occurred within six months of developing ocular GVHD in 60% of the cases and within the first year in 76%. High IOP normalized in 67% of patients when the dosage of topical or systemic corticosteroids was lowered, and 27% of patients required anti-glaucoma therapy. Conclusion Ocular hypertension is a common complication in patients with ocular GVHD, with a prevalence of 15%. The rise in intraocular pressure is often transient and resolves with management of corticosteroids in most cases. However, clinicians should be aware that nearly one-third of the patients with OHT might require anti-glaucoma treatment. The prevalences of glaucoma and suspicion of glaucoma were not higher than in the general population.