Prospective, long-term evaluation of steroid-induced glaucoma.
OBJECTIVE
To evaluate the intraocular pressure (IOP) after cessation of steroid use in steroid-induced glaucoma and its control with medication or surgery.


METHODS
Thirty-four eyes of 34 patients having steroid-induced glaucoma were prospectively evaluated after cessation of steroid for IOP, visual acuity, and optic disc status at 3 months, and every 3 months for 18 months.


RESULTS
Topical steroid use (73.5%) was the most frequent cause for glaucoma. The baseline IOP was 35.47+/-12.59 mmHg. The baseline vertical cup-disc ratio correlated with duration of steroid use (P=0.014) and the baseline IOP (P<0.0001). In 25 patients (73.5%), IOP could be controlled by topical medications alone, whereas nine patients (26.5%) required surgery. The mean baseline IOP in eyes requiring surgery was 49.67+/-13.28 mmHg and in eyes managed medically, 30.36+/-7.51 mmHg (P=0.002). The vertical cup-disc ratio in surgically treated patient was 0.87+/-0.13:1 as compared to 0.71+/-0.15:1 (P=0.012) in the medically treated group. At 6, 12, and 18 months follow-up, 22 (64.7%), 33 (97.1%), and all 34 (100%) patients were off treatment, respectively.


CONCLUSIONS
Patients with steroid-induced glaucoma, who were <or=20 years old, with a higher IOP, and greater glaucomatous optic neuropathy, were more likely to need surgery. After cessation of steroid therapy, all eyes were off treatment at 18 months.
Sihota
R
R
Glaucoma Research Facility, Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Konkal
V L
VL
Dada
T
T
Agarwal
H C
HC
Singh
R
R
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005901:Glaucoma / Q000139:chemically induced*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000139:chemically induced; D011446:Prospective Studies; D013223:Statistics as Topic; D013256:Steroids / Q000009:adverse effects*; D014130:Trabeculectomy / Q000379:methods
D013256:Steroids