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Meenakshi Chaku, Steve Charles, Peter A. Netland; Corticosteroid Exposure in Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5047.
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Elevation of intraocular pressure has been observed with various corticosteroid formulations for both ocular and non-ocular indications. The use of corticosteroids for differing indications may not be identified in glaucoma patients unless specifically solicited. The purpose of this study is to evaluate the prevalence of corticosteroid use in a subset of glaucoma patients.
In this prospective study, one hundred patients in a tertiary referral glaucoma clinic were studied using a detailed questionnaire requiring documentation of corticosteroid use, including type of formulation, duration and indications. Topical corticosteroids used short term post-operatively were not included as exposure. Physician examiners queried the patients and recorded responses. The results were tabulated and analyzed.
One hundred glaucoma patients were included in the study (98 primary open angle glaucoma, 1 combined mechanism glaucoma, and 1 pseudoexfoliation glaucoma). The average age was 69.6 ± 12.5 yrs (range: 36-98 yrs old). 59% were female and 41% male. Overall, 53% were treated with at least one type of corticosteroid modality. This included 29% oral systemic use, 28% local injections, 10% topically (for dermatological use), 4% respiratory inhalers, 4% topical ophthalmic drops, and 1% nasal sprays. Many of these patients (17%) documented use of more than one formulation at some point in time. The indications included 20% for pain management, 16% dermatological use, 15% for rheumatologic use, 9% pulmonary related, 4% sinus related, 4% other uses (transverse myelitis, sarcoidosis, unspecified cancer, renal transplant), 3% ocular use, and 2% for seasonal allergies.
More than half of the patients sampled in our tertiary referral glaucoma clinic reported corticosteroid use and many of these patients were using more than one formulation at the same time. Corticosteroid use may be common in glaucoma patients, and a targeted history is helpful to identify various formulations and indications for use of corticosteroids in these patients.
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