Ocular hypertensive and anti‐inflammatory responses to different dosages of topical dexamethasone in children: a randomized trial

Lam, Dennis S.C.; Fan, Dorothy S. P.; Ng, Joan S.K.; Yu, Christopher B O; Wong, Chun yu; Cheung, Albert Y.

doi:10.1111/j.1442-9071.2005.01022.x

Cited by 85 publications

(55 citation statements)

References 33 publications

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“…[1][2][3][4][5] Many risk factors, such as age, 4,5,28 steroid administration technique, 4 and diagnosis of open-angle glaucoma, 1,2,[29][30][31] are associated with the IOP elevation in response to steroid administration. These findings imply that changes in cellular behaviors caused by steroids may differ between patients.…”

Section: Discussionmentioning

confidence: 99%

Involvement of RhoA/Rho-Associated Kinase Signal Transduction Pathway in Dexamethasone-Induced Alterations in Aqueous Outflow

Fujimoto

Inoue

Kameda

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. We investigated the involvement of the RhoA/Rho kinase (ROCK) signal transduction pathway in dexamethasone (DEX)-induced changes in aqueous outflow.METHODS. Using trabecular meshwork (TM) and Schlemm's canal endothelial (SCE) cells, RhoA activation was evaluated with a pull-down assay and myosin light chain phosphorylation was evaluated by Western blot analysis. Outflow facility was measured in perfused porcine anterior segment organ cultures treated with DEX and/or Y-27632, a selective ROCK inhibitor. The barrier function of the cultured cells on a micropore filter was evaluated by measuring the transendothelial electrical resistance. Collagen, fibronectin, and integrin mRNA expression levels were evaluated by quantitative realtime RT-PCR. RESULTS.Relative RhoA activities increased following stimulation with 100 nM DEX in TM and SCE cells. Perfusion with DEX decreased outflow facility by 31.9 6 14.3% compared to controls at 24 hours, but not by 50 lM Y-27632 in addition to DEX. The transendothelial electrical resistance of the SCE cell monolayer was increased by 48.6 6 6.4% and 5.3 6 5.0% following DEX treatments without and with 10 lM Y-27632, respectively, compared to controls. In TM cells, the mRNA expressions of COL4A1 and fibronectin were increased significantly by DEX treatment, but combined treatment with Y-27632 and DEX significantly inhibited the increase in COL4A1and fibronectin expression.CONCLUSIONS. Activation of the Rho/ROCK pathway in SCE cells contributes to the mechanism of DEX-induced changes in aqueous outflow. (Invest Ophthalmol Vis Sci. 2012;53:7097-7108) DOI:10.1167/iovs.12-9989 S teroid-induced ocular hypertension is an important clinical problem related to the use of glucocorticoid therapy for many types of disorders. Already in 1963, Armaly reported that the widely used glucocorticoid dexamethasone (DEX) induces changes in intraocular pressure (IOP) and fluid dynamics in normal eyes, and that DEX-induced IOP elevation is observed more frequently in the patients with glaucoma. 1-3 IOP levels often are quite high in patients with steroid-induced ocular hypertension, and prolonged IOP elevation sometimes results in the loss of visual function. Topical administration of triamcinolone acetonide (TA), a synthetic corticosteroid, is considered a useful therapeutic modality for the management of intraocular inflammatory and/or proliferative diseases. The increasing number of patients treated with TA by intravitreous and/or sub-Tenon injections, however, has attracted the attention of ophthalmologists because of the potential risk of steroid-induced ocular hypertension. 4,5The mechanisms underlying steroid-induced ocular hypertension are associated with abnormal changes in the conventional outflow pathway caused by steroid administration. Some researchers attribute the decreased outflow to an accumulation of extracellular matrix (ECM) components, such as glycosaminoglycans, collagens, fibronectin, and elastin. [6][7][8][9] Others have proposed that the decreased outflow is due to decrea...

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Section: Discussionmentioning

confidence: 99%

Involvement of RhoA/Rho-Associated Kinase Signal Transduction Pathway in Dexamethasone-Induced Alterations in Aqueous Outflow

Fujimoto

Inoue

Kameda

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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“…IOP elevation in response to topical dexamethasone occurs more frequently, more severely and more rapidly in children compared with adults [40]; this response was also found to be dose and age dependent [41,42]. Younger aged children had a higher peak of IOP and attained the peak IOP earlier.…”

Section: Reviewmentioning

confidence: 80%

Intraocular pressure elevation in uveitis

Din

Isa

Taylor

et al. 2012

Expert Review of Ophthalmology

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“…15,29,30 A escolha da prednisona baseou-se na revisão de literatura a respeito do efeito hipertensivo ocular dos corticóides 16,17,18,19,20,21,22 e para efeito de comparação com o grupo tratado com o meloxicam, o corticóide foi administrado pela mesma via de administração e utilizado pelo mesmo período de tratamento.…”

Section: Discussionunclassified

“…Este efeito pode ocorrer independentemente da dose, dose total, duração do tratamento, fármaco 20 , via de administração 19,20,21,22 e, quanto maior a capacidade anti-inflamatória do AIE, maior a probabilidade de elevação da PIO 19,21 . Entretanto, mesmo após anos de conhecimento sobre a relação entre o uso de antiinflamatórios esteroidais e o aumento da pressão intra-ocular, a patogênese desta desordem carece de maiores esclarecimentos.…”

Section: Introductionunclassified

Meloxicam e prednisona: efeitos do tratamento oral de curto prazo sobre os níveis de pressão intra-ocular em cães

Fusco

Telhado

Pereira³

et al. 2009

Braz. J. Vet. Res. Anim. Sci.

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ResumoPara possível observação da hipertensão ocular com o uso de antiinflamatórios, foram selecionados 28 cães da raça Beagle. Para avaliação da pressão intra-ocular antes do tratamento, no dia 0 (zero) todos os animais tiveram a pressão intra-ocular avaliada às 08 horas e às 16 horas. No dia seguinte dez cães receberam meloxicam na dose de 0,2 mg/kg, e 0,1mg/kg nos restantes quatro dias. Nove cães receberam prednisona na dose de 1,0 mg/kg durante cinco dias. Nove cães receberam somente porção de ração úmida. No quinto dia do tratamento todos os animais tiveram novamente a pressão intraocular avaliada às 08 horas e às 16 horas. Em todos os grupos, incluindo o grupo-controle, as maiores médias de pressão intra-ocular foram observadas no dia 5 (cinco). A diferença dos valores de pressão intra-ocular observada entre as medições das 08 horas e das 16 horas foi significativa, independente do tratamento e do dia considerado. O uso dos anti-inflamatórios esteroidal e não-esteroidal não foi capaz de causar hipertensão ocular e alguns fatores podem ser incriminados, como via de administração, dose e duração do tratamento utilizado, além da ausência de doença glaucomatosa nos cães selecionados. Palavras-chave:Cão. Hipertensão ocular. Anti-inflamatório não-esteroidal. Glicocorticóide IntroduçãoO humor aquoso contido no olho exerce pressão contra a parede do bulbo ocular com uma força que é denominada pressão intra-ocular (PIO). 1A hipertensão ocular constitui um fator de risco para o desenvolvimento de glaucoma 2,3,4,5 , sendo este fator o único passível de tratamento 3,6 . O glaucoma é definido como uma neuropatia óptica anterior progressiva caracterizada por escavação e atrofia do disco óptico e decréscimo na funcionalidade da retina 2,7,8 , geralmente acompanhada por valores de PIO maiores que 25 mmHg 9 . Sendo os danos irreversíveis e tendo a cegueira como resultado final, o diagnóstico e tratamento precoces seriam formas eficientes de retardar o seu aparecimento.

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Ocular hypertensive and anti‐inflammatory responses to different dosages of topical dexamethasone in children: a randomized trial

Cited by 85 publications

References 33 publications

Involvement of RhoA/Rho-Associated Kinase Signal Transduction Pathway in Dexamethasone-Induced Alterations in Aqueous Outflow

Involvement of RhoA/Rho-Associated Kinase Signal Transduction Pathway in Dexamethasone-Induced Alterations in Aqueous Outflow

Intraocular pressure elevation in uveitis

Meloxicam e prednisona: efeitos do tratamento oral de curto prazo sobre os níveis de pressão intra-ocular em cães

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