Steroid-induced glaucoma and blindness in vernal keratoconjunctivitis
| Autor: | Harsha L. Rao, Ganesh B. Jonnadula, Sirisha Senthil, Monica Thakur, Ashik Mohamed, Virender S Sangwan, Chandra S. Garudadri |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Intraocular pressure medicine.medical_specialty genetic structures Adolescent medicine.medical_treatment Glaucoma Ocular hypertension India Blindness 03 medical and health sciences Cellular and Molecular Neuroscience Young Adult 0302 clinical medicine Age Distribution Ophthalmology medicine Glaucoma surgery Prevalence Humans Sex Distribution Child Conjunctivitis Allergic Retrospective Studies 030201 allergy business.industry medicine.disease eye diseases Sensory Systems Visual field medicine.anatomical_structure Logistic Models Cohort 030221 ophthalmology & optometry Female Steroids sense organs business Vernal keratoconjunctivitis Optic disc |
| Zdroj: | The British journal of ophthalmology. 104(2) |
| ISSN: | 1468-2079 |
| Popis: | PurposeTo report the clinical features, treatment outcomes and blindness associated with steroid-induced glaucoma in vernal keratoconjunctivitis (VKC).Materials and methodsRecords of patients with VKC, who visited our tertiary centre from 1992 and 2009, were reviewed and those with steroid-induced glaucoma were included in the study. Glaucoma was diagnosed based on intraocular pressure (IOP) ≥22 mm Hg on two consecutive visits (ocular hypertension) and/or glaucomatous optic disc damage. Blindness was defined as best corrected visual acuity of ≤20/400 or visual field ResultsOf the 4062 VKC subjects, 91 (157 eyes) had steroid-induced glaucoma (SIG), showing a prevalence of 2.24%. Of these 87% were men. The median (IQR) age at onset of VKC was 12 years (7–17). At presentation, the median duration of VKC was 48 months (24–72) and the median duration of steroid usage was 24 months (12–36). The median cup-to-disc ratio (CDR) was 0.9 (0.7–0.9) and median mean deviation was −21.9 dB (−30.0 to –10.2). IOP was medically controlled in 66% eyes (104/157) and 34% eyes (53/157) needed glaucoma surgery. High presenting IOP (OR: 1.04; p=0.05) and increased duration of steroid usage (OR: 1.07; p=0.02) were significantly associated with need for glaucoma surgery. At presentation, 29/91 subjects (31.8%) were bilaterally blind due to SIG. Higher CDR at presentation was significantly associated with blindness in this cohort (p=0.02).ConclusionIn this cohort of VKC with SIG, the disease predominantly affected adolescent males. Glaucoma was severe with one-third needing surgery and one-third blind due to SIG. |
| Databáze: | OpenAIRE |
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