Do reducing regimens of fluorometholone for paediatric ocular surface disease cause glaucoma?
Title | Do reducing regimens of fluorometholone for paediatric ocular surface disease cause glaucoma? |
Publication Type | Journal Article |
Year of Publication | 2011 |
Authors | Mataftsi, A., Narang A., Moore W., & Nischal K. K. |
Journal | Br J Ophthalmol |
Volume | 95 |
Issue | 11 |
Pagination | 1531-3 |
Date Published | 2011 Nov |
ISSN | 1468-2079 |
Keywords | Adolescent, Blepharitis, Child, Child, Preschool, Drug Administration Schedule, Female, Fluorometholone, Glaucoma, Glucocorticoids, Humans, Infant, Keratoconjunctivitis, Male, Ophthalmic Solutions, Postoperative Care, Retrospective Studies, Strabismus |
Abstract | BACKGROUND/AIMS: Although fluorometholone (FML) is considered a steroid of minimal ocular penetration, reports in children have shown dose-dependent intraocular pressure (IOP) rise. The authors aimed to assess whether reducing regimens of FML for paediatric ocular surface disease have sustained clinically significant ocular hypertensive effects.METHODS: Retrospective case-note review. Glaucoma was defined as an IOP of ≥ 21 mm Hg on at least two occasions or, in young children, moderate/firm digital IOP with one of the following: myopic shift, increased cup:disc ratio or corneal oedema. Exclusion criteria were other concurrent steroids or pre-existing optic nerve disease.RESULTS: 107 cases were included. The median age was 6 years (range 3 months to 17 years). The commonest indication for FML was blepharo-kerato-conjunctivitis. The maximal frequency prescribed was four times a day, gradually reduced to once weekly in cases of long-term treatment. The mean total number of eye-drop applications was 228 over a mean time span of 9 months. Post-FML IOP was formally documented in 51/107 casenotes (median age 6.85 years, range 4 months to 16 years) and it was <19 mm Hg in all cases. 56 cases did not allow IOP measurement (median age 5.9 years, range 3 months to 17 years), but none met the glaucoma definition.CONCLUSIONS: In this cohort, reducing regimens of FML proved to be a safe anti-inflammatory treatment in terms of avoiding steroid-induced glaucoma. |
DOI | 10.1136/bjo.2010.192773 |
Alternate Journal | Br J Ophthalmol |
PubMed ID | 21296793 |