Chapter 23: Steroid-Induced Glaucoma

Mihalache Andrew, Huang Ryan S, Balas Michael et al.

von Arenstorff Mathilde Mussmann, Kessel Line, Rasmussen Marie Louise Roed et al.

Trabeculotomy effectively controlled steroid-induced pediatric glaucoma for 24 months without medication, even with continued steroid use. This safe procedure should be considered early when medical therapy fails.

Levenson Jeffrey, Walters Thomas R, Martel Joseph et al.

Clobetasol propionate 0.05% BID effectively reduced post-cataract surgery inflammation with good safety and no significant IOP increase, suggesting a promising new treatment option.

Kim Ji Hong, Kim Yunjin, Oraha Kathy Michelle et al.

Korean SLE patients have a higher glaucoma incidence, especially younger females and those on long-term steroids, necessitating regular ophthalmic screening and careful steroid management.

Ong Ariel Yuhan, Christou Evita Evangelia, Kiire Christine A et al.

This review addressed managing sight-threatening chorioretinal conditions in pregnancy. It found evidence supporting various treatments, including steroids and anti-VEGFs, balancing maternal vision with fetal safety, and clarifying delivery misconceptions.

Redmon Sarah N, Yarishkin Oleg, Rudzitis Christopher N et al.

Corticosteroids impair TREK-1 channels in the eye, hindering fluid outflow and raising pressure. Activating TREK-1 improves outflow and lowers intraocular pressure, offering a potential treatment for steroid-induced glaucoma.

Fricker Jules, Nahon-Esteve Sacha, Tick Sarah et al.

FAc implants improved vision and reduced treatment burden in radiation maculopathy, but required careful monitoring for intraocular pressure elevation.

Massenzio Samantha S, Zafar Sidra, Deaner Jordan D

This review found corticosteroids are key for uveitic macular edema, but new localized steroid and non-steroidal therapies aim to reduce side effects, improving vision while minimizing complications.

Serrar Yasmine, Sejournet Lucas, Thomeret Victor et al.

Multiple fluocinolone acetonide implants effectively treat chronic DMO. Second injections maintain similar visual and anatomical benefits and safety profiles as the first, supporting sustained treatment and repeatability for patients.

Gao Yuwan

Marshall Rayna F, Lee Daniel, Thorne Jennifer E et al.

This study found uveitic glaucoma incidence/prevalence decreased since 2013, but anterior and intermediate uveitis patients still face the highest risk, highlighting the need for vigilant monitoring in these groups.

Abu Ishkheidem Imadeddin, Breimer Martin, Kamal Saba et al.

This study found 37.9% of eyes developed ocular hypertension after dexamethasone implants, with male gender and higher baseline IOP as risk factors, requiring vigilant monitoring but usually manageable with drops.

Kodjikian Laurent, Duarte Lilianne, Singh Pankaj et al.

A decade of FAc implant use for DMO showed good efficacy and safety, despite IOP/cataract risks, offering a valuable sustained-release treatment option for patients.

Patel Nimesh A, Hoyek Sandra, López-Font Francisco J et al.

Sub-Tenon triamcinolone in pediatric patients showed a favorable safety profile, with low rates of temporary ocular hypertension and cataract, requiring no glaucoma treatment or surgery.

Wu Shi-Nan, Chen Xiao-Dong, Yan Dan et al.

Analyzing FDA data, 805 drugs were linked to glaucoma, with 46 showing significant risk, including steroids, anticholinergics, and VEGF inhibitors. Clinicians must be vigilant about these drug-induced glaucoma risks.

Wangyu Stephanie, Jung Jennifer L, Pecen Paula E et al.

A fluocinolone implant effectively treats pediatric uveitis, especially pars planitis, but carries a high risk of ocular hypertension requiring intervention, similar to adult use.

Wright Jessica A, Xu Sarah C, Wong Mitchell H et al.

This study found that individuals with reduced CYP3A4 steroid metabolizing phenotypes have a significantly higher rate of steroid-induced IOP elevation, which can help identify patients at risk.

Schmidt Diana Chabané, Martinussen Torben, Solebo Ameenat Lola et al.

This study found low-dose glucocorticoids after pediatric cataract surgery reduced glaucoma risk in children with longer eyes (≥18mm), suggesting high-dose use should be limited.

Zhang Nan, Zhang Pengyu, Deng Xizhi et al.

Nicotinamide riboside (NR) was found to mitigate glucocorticoid-induced glaucoma by reducing extracellular matrix deposition and mitochondrial damage in the trabecular meshwork, suggesting NR is a promising therapeutic for GIG.