Corneal topographic response to intraocular pressure reduction in patients with vernal keratoconjunctivitis and steroid-induced glaucoma.
OBJECTIVE
To study the corneal topographic response to IOP reduction in vernal keratoconjunctivitis (VKC) with steroid-induced glaucoma.


METHODS
A total of 42 eyes of 21 patients with VKC and steroid-induced glaucoma (Group I) and 66 eyes of 33 patients with VKC without glaucoma (Group II) underwent an evaluation by Orbscan topography. In eyes with glaucoma, the IOP was controlled medically and the corneal topography was repeated at 3 months to evaluate effect on corneal parameters.


RESULTS
The mean baseline IOP was 36.40+/-13.08 mmHg in Group I, 14.67+/-4.62 mmHg in Group II (P<0.0001). The IOP after treatment at 3 months follow-up was 15.00+/-5.41 mmHg in Group I (P<0.0001). In Group I, the mean maximum Sim K decreased from 44.86+/-3.21 D to 43.87+/-2.62 D (P=0.031) and mean posterior corneal elevation decreased from 64.9+/-22.36 microm to 35.7+/-28.91 microm at 3 months after reduction of IOP (P=0.001). There was a significant positive correlation between the reduction in the IOP and the decrease in the posterior corneal elevation (r=0.664, P=0.001).


CONCLUSIONS
Eyes with VKC with and without glaucoma have similar corneal topography. Increased IOP associated with steroid-induced glaucoma and VKC may contribute to an increase in the corneal curvature and posterior corneal elevation. These changes may be reversed by a reduction in the IOP with medical therapy.
Dada
T
T
Glaucoma Research Facility, Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. tanujdada@hotmail.com
Konkal
V
V
Tandon
R
R
Singh
R
R
Sihota
R
R
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001623:Betamethasone / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003233:Conjunctivitis, Allergic / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D003315:Cornea / Q000187:drug effects; D019781:Corneal Topography / Q000379:methods*; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005901:Glaucoma / Q000139:chemically induced* / Q000150:complications / Q000503:physiopathology; D006801:Humans; D006845:Hydrocarbons, Fluorinated / Q000008:administration & dosage / Q000009:adverse effects; D006854:Hydrocortisone / Q000008:administration & dosage / Q000009:adverse effects; D007429:Intraocular Pressure / Q000502:physiology*; D007637:Keratoconjunctivitis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D011278:Pregnanes / Q000008:administration & dosage / Q000009:adverse effects*; D011446:Prospective Studies
D000893:Anti-Inflammatory Agents; D006845:Hydrocarbons, Fluorinated; D011278:Pregnanes; C029999:fluoromethane; D003907:Dexamethasone; D001623:Betamethasone; D006854:Hydrocortisone