ABSTRACT
Objective:
To observe the clinical characteristics of
steroid-induced
ocular hypertension (SIOH) in
patients with
uveitis, and explore the relationship between its clinical
phenotype and
gene polymorphism.
Methods:
A retrospective
case-control study. From July 2019 to December 2020, 576
patients with
uveitis who were treated with
glucocorticoid eye drops in Tianjin Medical
University Eye Hospital were included in the study. Among them, there were 175 confirmed
glucocorticoid responders (SRs) and 401
glucocorticoid non-responders (NRs). Seventy cases of SRs (age ≥18 years) using 1 %
prednisone acetate eye drops were selected as the experiment group and 64 cases of NRs were selected as the
control group. The polymorphism of rs2523864 and rs3873352 of
human leukocyte antigen complex group ( HCG) 22
gene were detected by Sanger sequencing. To observe the clinical characteristics of SIOH after the use of
glucocorticoid eye drops, and the correlation between rs2523864 and rs3873352 and the occurrence of SIOH. Differences among groups were compared with the
Chi-square test or Fisher's exact test. The correlation between the occurrence of SIOH and the range of
intraocular pressure increases after
glucocorticoid use and the rs2523864 and rs3873352 loci were compared using the
odds ratio ( OR) and its 95%
confidence interval ( CI).
Results:
SIOH occurred in 175 (30.4%, 175/576) of 576
patients. Among them, there were 96
males (54.9%, 96/175) and 79
females (45.1%, 79/175); the average age was 33.64±17.40 years.
Steroid high responders (HRs) and
steroid moderate responders (MRs) were 58 (33.1%, 58/175) and 117 (66.9%, 117/175) cases. The medication
time for the increase in
intraocular pressure in MRs that was 33 (19, 56) days, and in HRs that was 28 (14, 36) days, the difference of which was significant ( Z=-1.999, P=0.046). No differences were found in daily doses of
ocular hypertension induced by 1%
prednisone acetate eye drops between MRs which was 4.24 (3.46, 4.66) drops/day and HRs that was 4.32 (3.84, 5.36) drops/day ( Z=-1.676, P=0.094). The
genotype and
allele frequency distribution of the rs3873352 locus in the case group and HRs group were significantly different from those in the
control group ( P<0.05). The
intraocular pressure with rs3873352 GG
genotype after the medication was higher than that with GC and CC
genotype ( Z=2.855, 2.628; P=0.013, 0.026), whereas there was no significant difference between different
genotypes of rs2523864 ( Z=3.580, P>0.05).
Genetic model analysis revealed the
risk of SIOH in rs3873352 G
allele carriers (GG+GC) was 2.048 times that of non-G
allele carriers ( OR=2.048, 95% CI 1.027-4.081, P=0.041). The
genotype and
allele frequency of rs2523864 locus showed no significant difference between different group ( P>0.05).
Conclusions:
After the use of
glucocorticoid eye drops, HRs have an earlier increase in
intraocular pressure than MRs. HCG22-rs3873352
gene polymorphism is related to the occurrence of SIOH, GG
genotype increases the
risk of SIOH, and G
allele is a
risk gene for SIOH.