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Abstract #20416 Published in IGR 10-1
Prospective, long-term evaluation of steroid-induced glaucoma
Sihota R; Konkal VL; Dada T; Agarwal HC; Singh REye 2008; 22: 26-30
PURPOSE: To evaluate the intraocular pressure (IOP) after cessation of steroid use in steroid-induced glaucoma and its control with medication or surgery. METHODS: Thirty-four eyes of 34 patients having steroid-induced glaucoma were prospectively evaluated after cessation of steroid for IOP, visual acuity, and optic disc status at 3 months, and every 3 months for 18 months. RESULTS: Topical steroid use (73.5%) was the most frequent cause for glaucoma. The baseline IOP was 35.47±12.59 mmHg. The baseline vertical cup-disc ratio correlated with duration of steroid use (P=0.014) and the baseline IOP (P<0.0001). In 25 patients (73.5%), IOP could be controlled by topical medications alone, whereas nine patients (26.5%) required surgery. The mean baseline IOP in eyes requiring surgery was 49.67±13.28 mmHg and in eyes managed medically, 30.36±7.51 mmHg (P=0.002). The vertical cup-disc ratio in surgically treated patient was 0.87±0.13:1 as compared to 0.71±0.15:1 (P=0.012) in the medically treated group. At 6, 12, and 18 months follow-up, 22 (64.7%), 33 (97.1%), and all 34 (100%) patients were off treatment, respectively. CONCLUSIONS: Patients with steroid-induced glaucoma, who were ≤20 years old, with a higher IOP, and greater glaucomatous optic neuropathy, were more likely to need surgery. After cessation of steroid therapy, all eyes were off treatment at 18 months.
Dr. Sihota, Glaucoma Research Facility, Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
Classification:
9.4.1 Steroid-induced glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
