N S Melberg1, R J Olk. 1. Washington University, Department of Ophthalmology, St. Louis, MO.
Abstract
PURPOSE: To examine the relationship between corticosteroid-induced ocular hypertension and the reduction and/or resolution of chronic aphakic or pseudophakic cystoid macular edema (CME). METHODS: The authors retrospectively reviewed 454 cases coded for CME between 1971 and 1991 and identified 21 patients with aphakic or pseudophakic CME greater than 6 months' duration who experienced a documented rise in intraocular pressure (IOP) on corticosteroid therapy. These patients were compared with similarly treated controls who did not experience a rise in IOP, and visual acuity and the biomicroscopic appearance of CME were examined. RESULTS: Sixteen of 21 patients showed improved visual acuity and reduction and/or resolution of CME. In all five cases of treatment failure, there was evidence of vitreous attachment to anterior segment structures. This is statistically significant compared with controls, in which 4 of 14 patients with normal vitreous anatomy showed similar improvement (P = 0.00003). CONCLUSION: This small retrospective series suggests that in the absence of vitreous traction, corticosteroid-induced ocular hypertension possibly leads to reduction and/or resolution of chronic aphakic or pseudophakic cystoid macular edema.
PURPOSE: To examine the relationship between corticosteroid-induced ocular hypertension and the reduction and/or resolution of chronic aphakic or pseudophakic cystoid macular edema (CME). METHODS: The authors retrospectively reviewed 454 cases coded for CME between 1971 and 1991 and identified 21 patients with aphakic or pseudophakic CME greater than 6 months' duration who experienced a documented rise in intraocular pressure (IOP) on corticosteroid therapy. These patients were compared with similarly treated controls who did not experience a rise in IOP, and visual acuity and the biomicroscopic appearance of CME were examined. RESULTS: Sixteen of 21 patients showed improved visual acuity and reduction and/or resolution of CME. In all five cases of treatment failure, there was evidence of vitreous attachment to anterior segment structures. This is statistically significant compared with controls, in which 4 of 14 patients with normal vitreous anatomy showed similar improvement (P = 0.00003). CONCLUSION: This small retrospective series suggests that in the absence of vitreous traction, corticosteroid-induced ocular hypertension possibly leads to reduction and/or resolution of chronic aphakic or pseudophakic cystoid macular edema.
Authors: Emily Y Chew; Adam R Glassman; Roy W Beck; Neil M Bressler; Gary E Fish; Fredrick L Ferris; James L Kinyoun Journal: Retina Date: 2011-02 Impact factor: 4.256