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Henrietta Ho, Jason Ho, Piergiacomo Grassi, Pouya Alaghband, Elizabeth Galvis, Alba De Antonio Ramiez, Rongxuan Lim, K Sheng Lim; Intraocular pressure change following the washout of topical ocular hypotensives medication. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2411.
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© ARVO (1962-2015); The Authors (2016-present)
To review the change in intraocular pressure (IOP) following the washout of topical medications in patients with ocular hypertension (OHT), primary open angle glaucoma (POAG) and uveitic glaucoma/secondary OHT (UG).
Patients were recruited from ongoing prospective clinical trials at St Thomas’ Hospital. All patients with UG were quiescent and no longer on treatment for inflammation. After baseline review, all participants had a minimum washout period of 1month duration of all topical ocular hypotensive medication, and phasing was performed to determine change in IOP.
A total of 120 POAG eyes, 36 OHT eyes and 50 UG eyes were included in the analysis. The mean pre-washout IOP was 18.2 ± 3.3 mmHg, 18.8 ± 3.3 mmHg and 17.9 ± 8.2 mmHg; the mean post-washout IOP was 26.5 ± 5.1 mmHg, 26.1 ± 3.8 mmHg, 22.5 ± 9.7 mmHg in POAG, OHT and UG, respectively. Post-washout, the mean increase in IOP was significantly lower in UG compared to POAG and OHT eyes (p=0.005). Between groups, the number of medication used did not significantly influence change in IOP. When patients with less than 6 months duration of treatment were excluded, the difference in IOP change in UG compared to POAG and OHT remained significant (p=0.007).
Although stopping medication resulted in an increase in mean IOP in all groups, the change was significantly lower in UG compared to POAG and OHT patients. Uveitis with elevated IOP is caused by active inflammation and steroid treatment. Therefore, once quiescent, there may be justification for reducing or eliminating glaucoma treatment in some of these patients.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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