TY - JOUR
T1 - Subtenon's depot corticosteroid injections in patients with a history of corticosteroid-induced intraocular pressure elevation
AU - Levin, Darrin S.
AU - Han, Dennis P.
AU - Dev, Sundeep
AU - Wirostko, William J.
AU - Mieler, William F.
AU - Connor, Thomas B.
AU - George, Varghese
AU - Eastwood, Dan
N1 - Funding Information:
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.
PY - 2002
Y1 - 2002
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=0036141498&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036141498&partnerID=8YFLogxK
U2 - 10.1016/S0002-9394(01)01372-1
DO - 10.1016/S0002-9394(01)01372-1
M3 - Article
C2 - 11812422
AN - SCOPUS:0036141498
SN - 0002-9394
VL - 133
SP - 196
EP - 202
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
IS - 2
ER -