Subtenon’s depot corticosteroid injections in patients with a history of corticosteroid-induced intraocular pressure elevation - 02/09/11
, Sundeep Dev, MD a, William J Wirostko, MD a, William F Mieler, MD a, Thomas B Connor, MD a, Varghese George, PhD a, Dan Eastwood, MS aAbstract |
PURPOSE: To determine whether a history of intraocular pressure elevation from local corticosteroid administration could predict subsequent intraocular pressure elevation after posterior subtenon’s corticosteroid injection.
METHODS: A retrospective review was performed of 64 consecutive patients (64 eyes) receiving posterior subtenon’s corticosteroid injection. Patients were categorized as either historical corticosteroid responders or nonresponders based on intraocular pressure response to topical corticosteroid drops in the same eye or to previous posterior subtenon’s corticosteroid injection of the fellow eye. Historical responders were defined as having a relative intraocular pressure increase of 5 mm Hg and absolute intraocular pressure greater than 24 mm Hg with an anatomically open angle. Relative risk of intraocular pressure elevation was evaluated based on historical response and presenting diagnosis.
RESULTS: Nine eyes were historical responders, and 55 eyes were historical nonresponders. A higher rate of recurrent intraocular pressure elevation developed in historical responder eyes (4 of 9, 44%) compared with nonresponders (7 of 55, 13%) after posterior subtenon’s injection (P = .04, Fisher’s test; P = .07, Kaplan-Meier analysis). Historical responders with uveitis were at significantly higher risk of intraocular pressure elevation than nonresponders without uveitis (hazard ratio = 10.8, P = .04, Cox proportional hazards). All but one eye that developed intraocular pressure elevation from posterior subtenon’s injection was adequately controlled with topical antiglaucoma therapy.
CONCLUSION: In nonglaucomatous eyes, a previous history of corticosteroid-induced intraocular pressure elevation is a relative, not absolute, contraindication to posterior subtenon’s corticosteroid injection, because the risk of intraocular pressure elevation is not absolute, and because it can usually be well controlled with topical antiglaucoma therapy.
Le texte complet de cet article est disponible en PDF.Plan
| ☆ | Dr Dev is a 1998–1999 AOS-Knapp, and R.G. Michels Fellow. Dr Wirostko is a 1998–1999 Heed Fellow. This work is supported in part by the Thomas M. Aaberg Retina Research Fund, Milwaukee, Wisconsin, by an unrestricted grant from Research to Prevent Blindness, Inc, New York, New York, and by National Eye Institute core grant EY01931, Bethesda, Maryland. |
Vol 133 - N° 2
P. 196-202 - février 2002 Retour au numéro
Article précédent
- Retinal nerve fiber layer analysis: relationship between optical coherence tomography and red-free photography
- Mohamed A.E Soliman, Thomas J.T.P Van Den Berg, Al-Araby A Ismaeil, Leo A.M.S De Jong, Marc D De Smet
- A Frame shift mutation in a tissue-specific alternatively spliced exon of collagen 2A1 in Wagner’s vitreoretinal degeneration
- Sanjoy K Gupta, Brian C Leonard, Karim F Damji, Dennis E Bulman
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?