THE PREVALENCE AND RISK FACTORS OF SECONDARY GLAUCOMA IN VOGT-KOYANAGI-HARADA SYNDROME: A SYSTEMATIC REVIEW AND META-ANALYSIS
Published 2024 - 28th ESCRS Winter Meeting
Reference: P177 | Type: Presented Poster & Poster | DOI: 10.82333/hj36-0r61
Authors: Abdelaziz Abdelaal 1 , Abdul Rhman Hassan* 2 , Basant Katamesh 3 , Mennatullah Eltaras 4 , Hashem Abu Serhan 5
1Harvard Medical School,Boston,United States, 2Wayne State University,Detroit,United States, 3Mayo clinic,Rochester,United States, 4Faculty of Medicine for Girls, Al-Azhar University,Cairo,Egypt, 5Hamad Medical Corporations,Doha,Qatar
Purpose
To determine the prevalence and risk factors of glaucoma in Vogt-Koyanagi-Harada (VKH) syndrome patients.
Setting
Knowing the exact burden of secondary glaucoma in VKH could guide its screening and management in clinical practice as a part of the regular follow-up for VKH patients.
Methods
The review protocol was pre-registered on PROSPERO [CRD42023462794]. PubMed, Scopus, Web of Science, EBSCOhost, and Google Scholar were searched for studies reporting the prevalence and/or risk factors of glaucoma in VKH. A manual search was also conducted to supplement the primary search. The primary outcome was the prevalence of glaucoma. Subgroup analyses based on glaucoma type, VKH stage, patients’ age, and follow-up were conducted. Secondary outcomes included risk factors of glaucoma in VKH. All analyses were conducted using STATA. Fixed- and random-effects models were selected according to the observed heterogeneity. Studies’ methodological quality was determined using the NIH tool.
Results
The analysis of 6890 eyes revealed a prevalence of secondary glaucoma of 20% (95%CI: 15-24%). The rate of glaucoma is lowest at VKH onset and higher as the follow-up period increases. Open-angle (12%; 95%CI: 9-14%) is more common than angle-closure glaucoma (7%; 95%CI: 3-13%). Glaucoma rate is highest in the chronic recurrent stage of VKH (33%; 95%CI: 12-59%) and among children <18 years of age (26%; 95%CI: 16-37%). Patients' age and gender, VKH stage, and the extraocular symptoms of VKH are not significant predictors of secondary glaucoma, while both posterior synechiae (logOR=0.58; 95%CI: 0.43-0.72) and disease recurrence (logOR=0.49; 95%CI: 0.34-0.63) are associated with a greater risk for secondary glaucoma. Studies' quality was good in 32 studies and fair in 5 studies. The certainty of evidence was moderate-to-high.
Conclusion
Glaucoma occurs in 1 in 5 VKH patients, with a higher tendency in children, chronic recurrent stages, and long-term follow-up. The presence of posterior synechiae and the recurrence of VKH are significant predictors of glaucoma in this patient population.