ADC_2010_505 - Acta Dermatovenerol Croat 2010;18(1:21-26 CLINICAL ARTICLE Vitiligo and Glaucoma An Association or a Coincidence A Pilot Study 1 1 2 3

ADC_2010_505 - Acta Dermatovenerol Croat 2010;18(1:21-26...

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21 Acta Dermatovenerol Croat 2010;18(1):21-26 CLINICAL ARTICLE Vitiligo and Glaucoma – An Association or a Coincidence? A Pilot Study Veljko Rogošić 1 , Lovro Bojić 1 , Neira Puizina-Ivić 2 , Lucija Vanjaka-Rogošić 3 , Marina Titlić 4 , Damir Kovačević 5 , Darko Duplančić 6 , Damir Sapunar 7 , Zoran Đogaš 7 1 University Department of Ophthalmology, 2 University Department of Dermatology and Venereology, Split University Hospital Center; 3 Vanjaka Rogošić Private Dermatology and Venereology Surgery; 4 University Department of Neurology, Split University Hospital Center, Split; 5 University Department of Ophthalmology, Rijeka University Hospital Center, Rijeka; 6 University Department of Medicine, Split University Hospital Center; 7 School of Medicine, University of Split, Split, Croatia Corresponding author: Veljko Rogošić, MD, PhD University Department of Ophthalmology Split University Hospital Center Spinčićeva 1 HR-21000 Split Croatia [email protected] Received: June 29, 2009 Accepted: December 18, 2009 SUMMARY Our aim was to draw attention of clinicians, dermatovenereologists and ophthalmologists to the possible association of vitiligo and ocular findings characteristic of primary open angle glaucoma (POAG). According to our clini- cal experience, POAG is relatively often diagnosed or previously diagnosed in patients treated for vitiligo. We found no literature report directly connecting vit- iligo and POAG. The articles mentioning glaucoma, i.e. increased intraocular pressure (IOP), are mainly based on secondary type of glaucoma as a direct consequence of vitiligo treated by corticosteroids. On the other hand, there is a substantial number of articles elaborating the association of vitiligo with ocular findings in known clinical syndromes. During a 2-year period, from May 2007 to May 2009, 42 patients with vitiligo were examined at University Department of Dermatology and Venereology and referred for previously appointed oph- thalmologic examination at University Department of Ophthalmology, Split Uni- versity Hospital Center. All patients with vitiligo underwent complete ophthal- mologic examination including visual field analysis, in order to treat and follow up or diagnose newly discovered POAG. Of 42 patients with vitiligo suspect of glaucoma, POAG was confirmed in 24 (57%) patients. Age median of all vitiligo patients was 56 (range 19-82) years. In patients with vitiligo and glau- coma, the duration of vitiligo was twofold that recorded in patients with vitiligo alone, the difference being statistically significant (z=3.3; P <0.001). The risk of developing glaucoma in vitiligo patients was 4.4-fold in >56 age group versus <56 age group and 3.5-fold in patients with >13 year versus patients with <13 year duration of vitiligo. Multivariate logistic regression for glaucoma develop- ment according to vitiligo duration (≤13 years vs . ≥13 years) and patient age (≤56 years vs . ≥56 years) pointed to the association of glaucoma develop- ment and age and yielded a 92% probability for the association of glaucoma development and vitiligo duration. Therefore, we believe that patients treated
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