Short-term, high-dose systemic steroids and intraocular pressure

Gehlen, Marcelo; Canto, Ana Paula; Skare, Thelma Larocca; Araújo, Francisco; Haider, Osvaldo

doi:10.3129/i09-072

Cited by 4 publications

(2 citation statements)

References 3 publications

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“…An increase of 10.8% was detected in the patients, but the difference was not statistically significant. Although the average IOP was on the safe side, 2 of 30 patients had an IOP of >20 mm Hg [15]. The lack of agreement between our study and the aforementioned study may be due to the type of systemic disease of the participants.…”

Section: Discussioncontrasting

confidence: 54%

Correlation between Peak Intraocular Pressure of the Water Drinking Test and Peak Intraocular Pressure Induced by Intravenous Methylprednisolone Pulse Therapy

Kowsarnia¹,

Aflaky

Banifatemi

et al. 2013

Ophthalmic Res

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Purpose: It was the aim of this study to determine any possible correlation between the peaks and changes in intraocular pressure (IOP) of a water drinking test and intravenous methylprednisolone pulse therapy (IVMPT) IOP response. Methods: Patients with rheumatic disorders scheduled for IVMPT with normal ocular examination received a WDT before and after 3 days of IVMPT. The maximum value of IOPs detected during the WDT or IVMPT was regarded as peak IOP, and IOP change was defined as the difference between peak IOP and baseline IOP. Results: The mean ± standard deviation (SD) IOPs on the first (21.9 ± 4.6 mm Hg; p = 0.04), second (21.9 ± 4.1 mm Hg; p = 0.03) and third (21.3 ± 4.2 mm Hg; p = 0.01) days of 20 enrolled patients were greater than that at baseline (19.3 ± 2.8 mm Hg). The mean ± SD of peak IVMPT IOP response was 23.9 ± 3.7 mm Hg, and IVMPT IOP change was 4.6 ± 3.7 mm Hg. These values for the first and second WDTs were 22.9 ± 4.9 and 3.9 ± 4.07 as well as 24.1 ± 4.6 and 3.00 ± 2.9 mm Hg, respectively. A significant correlation was observed between the first WDT and IVMPT IOP changes (r = 0.5, p = 0.007) and peak IOPs (r = 0.6, p = 0.001). Conclusion: WDT, a low-cost and feasible test in clinical practice, may be a useful tool in determining the IOP peak and change following IVMPT.

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Section: Discussioncontrasting

confidence: 54%

Correlation between Peak Intraocular Pressure of the Water Drinking Test and Peak Intraocular Pressure Induced by Intravenous Methylprednisolone Pulse Therapy

Kowsarnia¹,

Aflaky

Banifatemi

et al. 2013

Ophthalmic Res

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“…Es konnte gezeigt werden, dass bei kontinuierlicher systemischer Steroidanwendung nach 4 Jahren im Mittel ein stärkerer Druckanstieg vorlag als nach einem Jahr [26]. Dass die Dauer der Steroidtherapie einen stärkeren Einfluss auf das Ausmaß der IOD-Steigerung hat als die Dosis, zeigt sich auch beim Beispiel einer Steroidstoßtherapie mit 1000 mg Methylprednisolon täglich über 3 Tage: Hierunter kommt es nur zu einem moderaten IOD-Anstieg von etwa 1-2 mmHg [27]. " hintere Schalentrübung der Linse " Pseudophakie in jüngeren Jahren " kürzlich durchgeführte Augenoperation " Morbus Cushing ("Vollmondgesicht") " atopische Diathese " Allergien " Autoimmunerkrankungen " Z. n. Organtransplantation " IOD-Anstieg in zeitlichem Zusammenhang mit einer Steroidapplikation…”

Section: Art Der Applikationunclassified

Klinik und Therapie des Steroidglaukoms

Rüfer¹,

Uthoff²

2013

Klin Monatsbl Augenheilkd

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In steroid responders, topical or systemic application of steroids leads to extracellular deposits in the trabecular meshwork which increase trabecular meshwork outflow resistance. 30-40 % of the normal population are steroid responders. About 5 % develop an intraocular pressure (IOP) rise of > 15 mmHg. These patients are termed "high responders". In patients with primary open angle glaucoma (POAG), the proportion of steroid responders sums up to 90 %. The extent of steroid response depends on the kind of steroid used and on the duration of its administration. Dexamethasone has the highest IOP increasing potency. Differential diagnoses are POAG, ocular hypertension, normal tension glaucoma, pseudoexfoliation glaucoma and secondary glaucoma due to different reasons. To make the diagnosis, a detailed anamnesis is crucial. A recompensated IOP after the end of steroid use proves the diagnosis. The treatment of steroid glaucoma includes topical antiglaucoma medications, glaucoma filtration surgery, trabeculotomy, and laser surgery. So far, only few comparative studies on different treatment options have been published on steroid glaucoma. In some cases of therapy-resistant IOP increases following intravitreal or subconjunctival steroid administration, operative removal of the steroids can be considered. A gene therapy treatment of steroid glaucoma is still a topic of research.

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Präoperative Therapieumstellung vor filtrierender Glaukomchirurgie

et al. 2016

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The mean IOP rise of 3.14 mm Hg 3 weeks after replacement of antiglaucomatous eye drops by acetazolamide was short of missing statistical significance and seems to be clinically negligible for this relatively short period. The advantages of a lower postoperative fibrotic activity have to be weighed up against this change in IOP. Surprisingly, the effect of administration of local steroids for 3 weeks was minor compared to the effect of the switch from local to oral antiglaucomatous medication. Individual major IOP increases under the preoperative therapy change should be taken into consideration.

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Short-term, high-dose systemic steroids and intraocular pressure

Cited by 4 publications

References 3 publications

Correlation between Peak Intraocular Pressure of the Water Drinking Test and Peak Intraocular Pressure Induced by Intravenous Methylprednisolone Pulse Therapy

Correlation between Peak Intraocular Pressure of the Water Drinking Test and Peak Intraocular Pressure Induced by Intravenous Methylprednisolone Pulse Therapy

Klinik und Therapie des Steroidglaukoms

Präoperative Therapieumstellung vor filtrierender Glaukomchirurgie

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