Hypotony in patients with uveitis: The Multicenter Uveitis Steroid Treatment (MUST) trial

Purpose: To assess the prevalence of hypotony in patients with severe forms of uveitis. Methods: The Multicenter Uveitis Steroid Treatment (MUST) Trial, a randomized study, enrolled 255 patients. Patients with hypotony at the baseline visit were identified. Results: Twenty (8.3%) of 240 patients with sufficient data had hypotony. Hypotony was more common in patients with uveitis ≥5 years duration (odds ratio [OR]=5.0; p <.01), and in eyes with a history of ocular surgery (vitrectomy vs. none, OR=3.1; p=.03). Hypotony was less in patients with older age of uveitis onset (>51 years vs. <51 years, OR=0.1; p=.02), in Caucasian patients (OR=0.1; p <.01) compared to African American patients. Hypotonous eyes were more likely to have visual impairment (OR=22.9; p <.01). Conclusions: Hypotony is an important complication of uveitis and more commonly affects African-American patients, those with uveitis onset at a younger age, and those with longer disease duration. It is associated with visual impairment.