Clinical Study
Eye (2008) 22, 26–30; doi:10.1038/sj.eye.6702474; published online 23 June 2006
Prospective, long-term evaluation of steroid-induced glaucoma
R Sihota1, V L Konkal1, T Dada1, H C Agarwal1 and R Singh2
- 1Glaucoma Research Facility, Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
- 2Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
Correspondence: T Dada, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India. Tel: +91 11 26589695; Fax: +91 11 26588919; E-mail: tanujdada@hotmail.com
Received 19 October 2005; Revised 21 April 2006; Accepted 21 April 2006; Published online 23 June 2006.
Abstract
Purpose
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 49.6713.28 mmHg and in eyes managed medically, 30.367.51 mmHg (P=0.002). The vertical cup–disc ratio in surgically treated patient was 0.870.13:1 as compared to 0.710.15:1 (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 
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.
Keywords:
steroid-induced glaucoma, trabeculectomy
