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Granulomatous anterior uveitis: an uncommon and less well recognized side effect of topical ?-adrenergic agonists

Poster Details

First Author: M.Moutsou UK

Co Author(s):    S. Goyal              

Abstract Details


To present five cases of GAU developed by ?-adrenergic drops, including Apraclonidine, which were used for the management of uncontrolled glaucoma.


Topical ?-Adrenergic agonists are used as 2nd to 4th line agents in the management of glaucoma. Granulomatous anterior uveitis (GAU) is a rare but known side effect of Brimonidine. However, it has not been yet well described for Apraclonidine. The series of five cases of GAU described in this study, one of which on Apraclonidine, were seen in our glaucoma clinic in the last year. These patients had been on ?-adrenergic drops elsewhere before their referral to us for management of uncontrolled glaucoma.


Retrospective chart review and anterior segment photos of these patients will be presented.


All patients were elderly (>65years). Three patients developed GAU after at least a year of exposure to Brimonidine. One of these 3 patients was treated with topical steroids for some years as it was considered to be hypertensive uveitis on a background of primary glaucoma. One patient had previous history of GAU with Brimonidine and on challenge developed GAU within 9 months of restarting Brimonidine. One patient had hypersensitivity reaction to Brimonidine in the past and was changed to Apraclonidine but developed GAU more than 6 months after the substitution to Apraclonidine. In all cases, GAU was associated with other signs of hypersensitivity like conjunctival congestion, follicles, papillae and periocular dermatitis. In all cases GAU and the hypersensitivity settled after stopping the ?-adrenergic agent.


Clinicians dealing with management of glaucoma should be aware of GAU as a rare side effect of ?-adrenergic agonists, including Apraclonidine. FINANCIAL DISCLOSURE?: No

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