CORTISONIC GLAUCOMA:EPIDEMIOLOGICAL, CLINICAL AND THERAPEUTIC PROFILE (ABOUT 35 CASES)
Published 2024 - 28th ESCRS Winter Meeting
Reference: P182 | Type: Submission | DOI: 10.82333/b6vz-4k28
Authors: Ayad Rima* 1 , Roukaya chahir 1 , lamia ajdour 1 , zyad laftimi 1 , ghizlane daghouj 1 , loubna el maaloum 1 , bouchra allali 1 , asma el kettani 1
1ophtalmologie pediatrique,hopital20aout,Casablanca,Morocco
Purpose
- Cortisonic glaucoma is an iatrogenic glaucoma secondary to the prolonged administration of local or systemic corticosteroids for chronic, usually inflammatory, conditions.
- It is a serious, blinding condition that requires early treatment, hence the importance of screening and raising awareness.
The importance of screening and raising public awareness
The aim of our study is to analyze the epidemiological, clinical and therapeutic profiles.
Setting
We conducted a retrospective study of 35 patients hospitalized for cortisonic glaucoma in the pediatric ophthalmology department of August 20 Hospital (65 eyes) between January 2010 and January 2023
Methods
We conducted a retrospective study of 35 patients hospitalized for cortisonic glaucoma in the pediatric ophthalmology department of August 20 Hospital (65 eyes) between January 2010 and January 2023
Results
The mean age of our patients was 12 years, with a male predominance of 60%; atcds included vernal conjunctivitis in 49% of cases, chalazions in 20%, uveitis in 14%, blepharitis in 11% and episcleritis in 6%.
90% of patients were treated with local corticosteroids (dexamethasone-based eye drops) for an average of 4 years, and 15.3% with systemic corticosteroids at a dose of 1 mg/kg/d. The condition was bilateral in 86% of cases.
The most frequent reason for consultation was reduced visual acuity in 90% of cases.
On examination, the visual acuity was <1/10 in 60% of cases, mean Intra ocular pression was 32mmhg, on eye fundus the papillary excavation was <4/10 in 23% of cases, between 4-7/10 in 33%, >7/10 in 43%, the iridocorneal angle was open in all patients.
The visual field was systematically requested in all patients, showing a severe perimetric deficit in all.
Therapeutic management consisted in discontinuing local corticosteroid therapy and starting hypotonizing therapy in all patients (monotherapy in 15% of cases, dual therapy in 22% and quadritherapy in 63%).
Surgical treatment was indicated in 63% of cases (Trabeculectomy +/- 5 FU in 61%, combined surgery in 15%).
IOP stabilized in 80% after filtering surgery and in 35% after medical treatment
Visual field stabilized in 80% of cases
Conclusion
Prevention +++ and regular monitoring of intra ocular pression in patients on corticosteroid therapy.rational use of corticostreoid, especially topical