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Abstract #5763 Published in IGR 2-1
The influence of treatment of progressive edematous infiltrative ophthalmopathy on intraocular pressure
Rutecka-Debniak A; Krzystolik Z; Pilarska K; Krzyzanowska-Swiniarska B; Syrenicz A; Jarema AKlinika Oczna 1999; 101:195-200
PURPOSE: To evaluate the influence of systemic steroid therapy and retrobulbar irradiation on intraocular pressure (IOP) in patients with infiltrative-edematous Graves' ophthalmopathy. MATERIAL AND METHODS: The authors examined 76 patients divided into three groups: I: treated by irradiation only (15 patients); II: treated by irradiation and oral prednisone therapy (26 patients); III: treated by irradiation and intravenous methylprednisolone pulse therapy (35 cases). All patients underwent full ophthalmological examination (including IOP measurement, perimetry and gonioscopy) before, during, immediately after, and two to 20 months after, treatment. RESULTS: Increased IOP (21-31 mmHg) was observed in 54 patients (71%) before treatment. The iridocorneal angle was open in all eyes. Changes in perimetry were not characteristic of glaucoma. IOP was higher in patients with more severe ophthalmopathy. The authors recorded a transient increase of IOP during treatment in three patients only. Increased IOP immediately after therapy was observed in 16 patients with severe symptoms and signs of ophthalmopathy: in group I: 4/15 (27%); group II: 4/26 (15%); group III: 8/35 (23%). Higher IOP was recorded in ten patients two to 20 months after completion of treatment: from group I: 4/15 (27%); group II: 1/26 (4%); and group III: 5/35 (14%). In six of these ten patients, the authors observed recurrence of ophthalmopathy. In four patients higher IOP was the only deviation, and they needed local therapy. The mean values of IOP were lower in patients treated by steroid therapy in comparison to patients treated by irradiation only. The most rapid improvement of clinical status was observed in patients treated by methylprednisolone pulse therapy. CONCLUSIONS: The increase of IOP in patients with Graves' ophthalmopathy correlates with the severity and duration of eye disease. Systemic steroid therapy is more efficient in the reduction of IOP than irradiation of the retrobulbar tissue. These results suggest that combined therapy is the preferable method of treatment of progressive ophthalmopathy, including cases with increased intraocular pressure. LA: Polish
Dr., A. Rutecka-Debniak, Katedry i Kliniki Okulistyki (WS) PAM w Szczecinie <#>
Classification:
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)