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Abstract #6097 Published in IGR 2-2
Corticosteroid-induced pseudocongenital glaucoma
Calixto N; Silva SMN; Cronemberger S; Milhomens ERevista Brasileira de Oftalmologia 2000; 59: 179-190
PURPOSE: To establish, retrospectively, a clinical picture of the corticosteroid-induced pseudocongenital glaucoma according to the data obtained in examinations of 33 children (mean age 7 ± 6.8 months). SETTING: Glaucoma Service of the Sao Geraldo Hospital UFMG. METHODS: Retrospective analysis of the anamnesis, applanation tonometry, measurement of the horizontal corneal diameter, echobiometry, biomicroscopy, gonioscopy and biomicroscopy of the eye fundus. RESULTS: Fifty-five eyes were exposed to the corticosteroid and forty (73%) developed an increase in the IOP. Fourteen children (42.4%) presented glaucoma in one eye, despite using it in both eyes. Corticosteroids were prescribed for treatment of epiphora and conjunctivitis in 94% of eyes. The mean time of use was 2.7 ± 1.8 months. The eye drops most frequently used were dexamethasone and betamethasone. The biomicroscopy showed corneal edema and Descemet ruptures in 95%, while the iris and the crystalline lens were normal. Gonioscopically the sinus was normal with outer wall free. The C/D ratio was greater than 0.5 in 70% of the eyes at the first examination. Interruption of the corticosteroids alone or associated with medical treatment normalized the IOP in four eyes. Trabeculotomy was the surgery of choice: IOP was normalized in all eyes in which it was performed. CONCLUSIONS: The clinical picture of cortisonic pseudocongenital differently of congenital glaucoma is characterized for: use and abuse of corticosteroid eye drops in clear eyes without hyperhemia and conjunctival exudates; negative family history of congenital glaucoma; corneal edema, Descemet ruptures and increased diameters; normal iris, crystalline lens and sinus; good response to clinical treatment or trabeculotomy (Choyce's surgery). LA: Portugese
Dr. N. Calixto, Rua Grao Mogol, 1177-Sion, Belo Horizonte-MG-CEP, 30315-600, Brazil
Classification:
9.1.1 Congenital glaucoma, Buphthalmos (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
