Do reducing regimens of fluorometholone for paediatric ocular surface disease cause glaucoma?

Abstract

BACKGROUND/AIMS:

Although fluorometholone (FML) is considered a steroid of minimal ocular penetration, reports in children have shown dose-dependent intraocular pressure (IOP) rise. The authors aimed to assess whether reducing regimens of FML for paediatric ocular surface disease have sustained clinically significant ocular hypertensive effects.

METHODS:

Retrospective case-note review. Glaucoma was defined as an IOP of ≥ 21 mm Hg on at least two occasions or, in young children, moderate/firm digital IOP with one of the following: myopic shift, increased cup:disc ratio or corneal oedema. Exclusion criteria were other concurrent steroids or pre-existing optic nerve disease.

RESULTS:

107 cases were included. The median age was 6 years (range 3 months to 17 years). The commonest indication for FML was blepharo-kerato-conjunctivitis. The maximal frequency prescribed was four times a day, gradually reduced to once weekly in cases of long-term treatment. The mean total number of eye-drop applications was 228 over a mean time span of 9 months. Post-FML IOP was formally documented in 51/107 casenotes (median age 6.85 years, range 4 months to 16 years) and it was <19 mm Hg in all cases. 56 cases did not allow IOP measurement (median age 5.9 years, range 3 months to 17 years), but none met the glaucoma definition.

CONCLUSIONS:

In this cohort, reducing regimens of FML proved to be a safe anti-inflammatory treatment in terms of avoiding steroid-induced glaucoma.

• Authors: Asimina Mataftsi, Aman Narang, Will Moore, Ken K Nischal
• Journal: The British journal of ophthalmology (Br J Ophthalmol) Vol. 95 Issue 11 Pg. 1531-3 (Nov 2011) ISSN: 1468-2079 [Electronic] England
• PMID: 21296793 (Publication Type: Journal Article, Review)

Chemical References

• Glucocorticoids
• Ophthalmic Solutions
• Fluorometholone

Topics

• Adolescent
• Blepharitis (drug therapy)
• Child
• Child, Preschool
• Drug Administration Schedule
• Female
• Fluorometholone (administration & dosage, adverse effects, therapeutic use)
• Glaucoma (chemically induced)
• Glucocorticoids (administration & dosage, adverse effects, therapeutic use)
• Humans
• Infant
• Keratoconjunctivitis (drug therapy)
• Male
• Ophthalmic Solutions
• Postoperative Care (methods)
• Retrospective Studies
• Strabismus (surgery)