The Research of Glaucomas Related to Topical and Systemic Steroids

Key Findings & Data:Material and Methods: Twenty-three eyes of 14 patients with steroid-induced glaucoma were retrospectively evaluated in the Ophthalmology Department of Yuzuncu Yil University between 1996 and 2009.

💡

Conclusion & Impact:The careful monitoring is essential for patients with glaucoma risk

🔬Design:Research Article

📍Scope:2009 Verileri

⚙️Variables:Domain Parameters

Abstract

Purpose: To evaluate the steroid-induced glaucoma and its treatment with medication or surgery. Material and Methods: Twenty-three eyes of 14 patients with steroid-induced glaucoma were retrospectively evaluated in the Ophthalmology Department of Yuzuncu Yil University between 1996 and 2009. All patients have increased IOP, glaucomatous optic disc damage and glaucomatous visual field loss. Results: The patient's mean age was 32.09±15.58. Topical steroid use was the most frequent cause for glaucoma (71.4%). Topical dexamethasone 0.1% was predominantly used by 13 eyes. The most common cause for steroid use was vernal keratoconjunctivitis (5 patients). The baseline and post-treatment IOP were 39±13.5 mmHg and 12.9±3.4 mmHg, respectively. The vertical cup-disc ratio was 0.69±2.2. In 9 patients (73.5%), IOP could be controlled by topical medications alone, whereas 5 patients (26.5%) required surgery. Conclusion: Steroid-induced glaucoma can occur with topical or systemic steroid administration. In the present study, IOP could have been controlled in all patients with medical or surgical therapy. Patients receiving potent topical or systemic steroids have a potential risk for increased IOP and glaucoma. Patients must be informed of this risk by their ophthalmologists. The careful monitoring is essential for patients with glaucoma risk

Özet

Amaç: Steroide bağlı glokomları ve tıbbi ya da cerrahi tedavilerini değerlendirmek. Gereç ve Yöntem: Yüzüncü Yıl Üniversitesi Göz Hastalıkları Ana Bilim Dalında, 1996-2009 arasında steroide bağlı glokomu bulunan 14 hastanın 23 gözü geriye dönük olarak incelendi. Tüm hastalar artmış göz içi basıncı (GİB), glokomatöz cup-disk hasarı ve glokomatöz görme alanı kaybına sahiplerdi. Bulgular: Hastaların ortalama yaşı 32.09±15.58 idi. Glokom için en sık sebep topikal steroid kullanımıydı (%71.4). On üç gözde deksametazon (%0.1) damla kullanılmıştı. Steroid kullanımın en sık sebebi vernal keratokonjunktivitti (5 hasta). Tedavi öncesi GİB 39±13.5, tedavi sonrası 12.9±3.4 mm Hg idi. Vertikal cup-disk oranı 0.69±2.2 idi. Dokuz hastada (%73.5) medikal tedavi ile GİB kontrol altına alınırken, 5 hastada (%26.5) cerrahi tedavi gerekti. Sonuç: Steroidin indüklediği glokom topikal ya da sistemik yolla olabilir. Bizim çalışmamızda GİB, tüm hastalarda medikal ya da cerrahi tedaviyle kontrol altına alınabilmiştir. Güçlü etkiye sahip topikal veya sistemik steroid tedavisi verilen hastalar GİB yüksekliği ve glokom açısından potansiyel bir riske sahiptir. Glokom riski olan hastalar için dikkatli takip esastır

🔖

Cite This Article

ÇAĞLAR, İ. Ç., ESMER, O., BATUR, M., SEVEN, E., YAŞAR, T. (2016). The Research of Glaucomas Related to Topical and Systemic Steroids. Glokom Katarakt, Cilt: 11 - Sayı: 3, 181–184. https://ajindex.com/articles/196192

References (19)

Heike S, Dietrich DW, Khusru A. Mechanisms involved in the side ef- fects of glucocorticoids. Pharmacology & therapeutics 2002;96:23-43.
Garbe E, Lelorier J, Boivin JF et al. Inhaled and nasal glucocorticoids and the risk of ocular hypertension or open angle glaucoma. JAMA 1997;277:722-7.
Armaly MF, Becker B. Intraocular pressure response to topical corti- costeroids. Fed Proc 1965;24:1274-8. Becker B. Intraocular pressure response to topical corticosteroids. In- vest Ophthalmol 1965;4:198-205.
Tripathi RC, Parapuram SK, Tripathi BJ et al. Corticosteroids and gla- ucoma risk. Drugs Aging 1999;15:439-50.
Bergmann J, Witmer MT, Slonim CB. The relationship of intranasal ste- roids to intraocular pressure. Curr Allergy Asthma Rep. 2009;9:311-5.
Han DP, Heuer DK. Intravitreal corticosteroid therapy: putting the problem of glaucoma in perspective. Arch Ophthalmol 2012;130:380-2.
Akyol N, Turgut B. Steroid glokomu. Glo-Kat 2006;1:239-44.
Urban RC, Dreyer EB. Corticosteroid-induced glaucoma. Int Ophthal- mol Clin 1993;33:135-9.
Sihota R, Konkal VL, Dada T et al. Prospective, long-term evaluation of steroid-induced glaucoma. Eye (Lond) 2008;22:26-30.
Munjal VP, Dhir SP, Jain IS. Steroid induced glaucoma. Indian J Oph- thalmol 1982;30:379-82.
Mohan R, Murlidharan AR. Steroid induced glaucoma and cataract. In- dian J Ophthalmol 1989;37:13-6. Herschler J. Increased intraocular pressure induced by repository corti- costeroids. Am J Ophthalmol 1976;82:90-3.
Goldstein DA, Fiscella RG, Tessler HH. Biochemical quantifica- tion of triamcinolone in subconjunctival depots. Arch Ophthalmol 1996;114:363-4.
Seven E, Çağlar Ç, Yaşar T. Hastalığının farkında olmayan, terminal evre steroide bağlı glokom olgusu. Glo-Kat 2010;5:235-8.
Bernstein HN, Schwartz B. Effects of longterm systemic steroids on ocu- lar pressure and tonographic values. Arch Ophthalmol 1962;68:742-53.
Bernstein HN, Mills DW, Becker B. Steroid-induced elevation of intra- ocular pressure. Arch Ophthalmol 1977;9:1075-80.
Jones R, Rhee JD. Corticosteroid-induced ocular hypertension and gla- ucoma: a brief review and update of the literature Curr Opin Ophthal- mol 2006:17;163-7.
Ohji M, Kinoshita S, Ohmi E et al. Marked intraocular pressure res- ponse to instillation of corticosteroids in children. Am J Ophthalmol 1991;112:450-4.
Kwok AK, Lam DS, Ng JS et al. Ocular-hypertensive response to topi- cal steroids in children. Ophthalmology 1997;104:2112-6.
Tripathi RC, Parapuram SK, Tripathi BJ et al. Corticosteroids an