The Effectiveness of Selective Laser Trabeculoplasty in Steroid-Induced Ocular Hypertension

Ju Hyang Lee; Min Cheol Seong; Hee Yoon Cho; Yoon Jung Lee

doi:10.3341/jkos.2011.52.7.876

Journal List > J Korean Ophthalmol Soc > v.52(7) > 1009090

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Lee, Seong, Cho, and Lee: The Effectiveness of Selective Laser Trabeculoplasty in Steroid-Induced Ocular Hypertension

Original Article

J Korean Ophthalmol Soc 2011;52(7):876-880.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.7.876

The Effectiveness of Selective Laser Trabeculoplasty in Steroid-Induced Ocular Hypertension

Ju Hyang Lee, MD, Min Cheol Seong, MD, Hee Yoon Cho, MD, Yoon Jung Lee, MD

Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea

Address reprint requests to Min Cheol Seong, MD Department of Ophthalmology, Hanyang University Guri Hospital #249-1 Gyomun-dong, Guri 471-701, Korea Tel: 82-31-560-8574, Fax: 82-31-564-9479, E-mail: goddns76@hanmail.net

Received 15 July 2010 Revised 28 December 2010 Accepted 12 April 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report the effectiveness of selective laser trabeculoplasty (SLT) in patients with intraocular hypertension refractory to maximum tolerated medical therapy after intravitreal triamcinolone acetonide (IVTA).

Case summary

The records of 3 patients with steroid-induced intraocular hypertension that did not respond to maximum tolerated medical therapy were retrospectively reviewed. The patients received SLT instead of filtering surgery or Argon laser trabeculoplasty. The mean intraocular pressure (IOP) of 13.7 mm Hg increased to 30.7 mm Hg within 13 days of IVTA. IOP was uncontrolled despite maximum tolerated medical therapy. Patients underwent SLT 15.3 weeks after IVTA. Mean IOP decreased to 16 ± 3.0 mm Hg after 1 day, 19.7 ± 8.0 mm Hg after 1 week, 17 ± 8.0 mm Hg after 1 month, 12.3 ± 2.9 mm Hg after 3 months and 12.3 ± 0.6 mm Hg after 4 to 6 months. The number of IOP lowering drugs were decreased to 1 from 4.3 after 6 months of SLT.

Conclusions

SLT may be effective and safe for the treatment of steroid-induced intraocular hypertension refractory to maximum tolerated medical therapy.

Keywords: Intravitreal triamcinolone acetonide injection, Selective laser trabeculoplasty, Steroid-induced ocular hypertension

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Figure 1.

Effects of selective laser trabeculoplasty in 3 patients with elevated IOP after intravitreal triamcinolone acetonide.

Table 1.

Summary demographics of 3 patients

	Case 1	Case 2	Case 3
Sex	M	M	M
Age (yr)	28	50	55
Preexisting diagnosis	PDR, ME	PDR, ME	BRVO, ME
BCVA	0.2	0.2	0.1
Preinjection IOP	13	12	14
Prior injection	None	IVTA × 3, Bevacizumab × 2	none

PDR = proliferative diabetic retinopathy; ME = macular edema; BCVA = best corrected visual acuity; IVTA = intravitreal triamcinolone acetonide injection.

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