Selective laser trabeculoplasty in steroid-induced and uveitic glaucoma
| Autor: | Yujia Zhou, Christopher M. Pruet, Chengbo Fang, Cheryl L. Khanna |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Intraocular pressure genetic structures Selective laser trabeculoplasty Glaucoma Trabeculectomy 03 medical and health sciences 0302 clinical medicine Ophthalmology Uveitic glaucoma medicine Humans Effective treatment Intraocular Pressure Retrospective Studies business.industry Lasers Baseline pressure General Medicine medicine.disease eye diseases Treatment Outcome Case-Control Studies Pseudoexfoliative glaucoma 030221 ophthalmology & optometry Steroids Laser Therapy sense organs business Complication Glaucoma Open-Angle |
| Zdroj: | Canadian Journal of Ophthalmology. 57:277-283 |
| ISSN: | 0008-4182 |
| DOI: | 10.1016/j.jcjo.2021.05.006 |
| Popis: | To compare primary selective laser trabeculoplasty (SLT) response in uveitic, steroid-induced, primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEX).Single-centre retrospective case-control study.Patients with uveitic glaucoma, steroid-induced glaucoma, POAG, or PEX who had their first SLT.Eyes with POAG or PEX were in control groups. Eyes with steroid-induced or uveitic glaucoma were in experimental groups. Change in intraocular pressure from baseline, treatment failure, complication rates, and medication use were compared using rank-sum and log-rank tests.Six-hundred and eight eyes of 433 patients were enrolled. Steroid-induced glaucoma eyes had higher mean baseline pressure and a decrease in pressure at 3-8 weeks (27.6-17.4 mm Hg) than those with PEX (21.7-16.5 mm Hg; p0.001) or POAG (18.6-14.9 mm Hg; p ≤ 0.025). Failure rates after 2 years were lower in steroid-induced glaucoma (54%) than in PEX (84%; p = 0.01) or POAG (84%; p = 0.005). This survival benefit persisted when excluding patients with changes to their steroid dosing (p ≤ 0.03) but showed mixed results when compared with patients with a baseline pressure of 25mm Hg or greater (p = 0.020 vs PEX; p = 0.67 vs POAG). At 18 months, the steroid-induced group decreased ocular hypotensive medication use (3.5-1.9; p = 0.005); the uveitic group increased medication use (2.7-3.5; p = 0.02).SLT is an effective treatment for steroid-induced glaucoma, with greater response and a lower failure rate than in PEX and primary POAG, although high baseline intraocular pressure may be a confounder. Judicious use of SLT can be considered in uveitic glaucoma. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect