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Thread: Pearls in Steroid Induced ocular HTN

  1. #1
    Join Date
    Oct 2017
    Riyadh, Saudi Arabia
    (Consultant Ophthalmologist at MALAZ MEDICAL GROUP)


    Default Pearls in Steroid Induced ocular HTN

    Pearls in Steroid Induced ocular HTN

    ✍️ steroids change the TM ability to process aqueous due Glycoaminoglycan accumulation

    ✍️ Alteration of TM endothelium phagocytotic ability

    ✍️ Prevent release of enzymes that normally depolymerize GAGs

    ✍️ Topical or oral corticosteroids can cause IOP rise

    ✍️ Ointment or creams periorbital and inhaled steroids can cause IOP increase

    ✍️ May be seen in patients endogenously producing excess steroids (e.g., Cushing’s syndrome)

    ✍️ 2 -5 weeks onset (often longer) to develop

    ✍️ About 2/3 of population are steroid responders

    ✍️ only 10% of steroid responders have significant problems

    ✍️ Response is dependent upon
    • Frequency
    • Dose
    • Genetic predisposition : TIGR/Myocillin gene( AR inheritance pattern).
    Pearls Steroid Induced ocular attachment.php?attachmentid=3467&d=1513498257

    High risk patients

    ✍️ Myopes
    ✍️ Pts with POAG
    ✍️ Children ( most dramatic response)


    ✍️ medication cessation
    ✍️ Aqueous suppressants( beta blockers, CAIs,..)
    ✍️ Prostaglandins
    ✍️ ALT or SLT (poor prognosis )
    ✍️ Trabeculectomy with or without antimetabolites

    Attached Images  
    Last edited by Reda Gomah El Garia; 12-17-2017 at 08:11 AM.

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