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   Table of Contents      
ARTICLE
Year : 1969  |  Volume : 17  |  Issue : 1  |  Page : 14-16

Steroid induced glaucoma (experimental study)


The Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Web Publication4-Jan-2008

Correspondence Address:
S D Gupta
The Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Gupta S D, Gupta J S, Gupta S B, Mahajan B G. Steroid induced glaucoma (experimental study). Indian J Ophthalmol 1969;17:14-6

How to cite this URL:
Gupta S D, Gupta J S, Gupta S B, Mahajan B G. Steroid induced glaucoma (experimental study). Indian J Ophthalmol [serial online] 1969 [cited 2020 Aug 13];17:14-6. Available from: http://www.ijo.in/text.asp?1969/17/1/14/37574

Table 2

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Table 2

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Table 1

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Table 1

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Corticosteroids locally in the eye and/or systemically have been and are being used extensively for a wide variety of inflammatory and allergic conditions in all branches of medicine and surgery. The anti-inflammatory effect is of great value in eye because it prevents the irrepairable damage to visual apparatus by the inflammatory process during its active stage.

In view of their widespread use, it is important to be familiar with its various adverse side effects. Their general untoward side effects are known for long but it was not till recently that long term corticosteroids topically in the eye and/or systemically were incriminated for posterior sub-capsular cataract (BLACK, OGLESBY, von SALLMANN AND B'UNIM[10]) and elevation of intraocular pressure with its subsequent sequela;. Though its effect on intra-ocular pressure has been sounded by many workers in human beings (ARMALY[1],[2]) and (BECKER AND MILLS[3]) and in animals (KOSAKI NAKATANI AND AZUMA[6]; SHEVALEY,[8]) there are certain reports which fail to confirm this finding (BLAKE, FASANELLA AND WONG[5]; TILLET[9]; LEE[7].) This subject being new and somewhat controversial, we thought it fit to study whether corticosteroids have any appreciable effect on intraocular pressure as studied usually in the ophthalmic departments.


  Methods And Material Top


The study was divided into two groups.

(1) Experimental (in rabbits)

(2) Clinical.

This is a preliminary report on experimental study.

This study included 15 rabbits. Normal tension was established for all the rabbits for three days. Tension was recorded under local anesthesia using 1 percent anethaine drops. Care was taken that the nictitating membrane did not come under the base of the tonometer. Tension was recorded each time by two weights (5.5 gm and 10 gm) and the mean of the two was taken as the correct reading. Rabbits were divided into two groups.

a) Topical steroid group: This consisted of nine rabbits. In one of the eyes Hydrocortisone acetate (Efcorlin) or Betamethasone (Betnesol) eye drops were used three times a day in each rabbit. The other eye served as control. In addition, subconjunctival injection of cortisone suspension (8 mg.) was given in the eye getting the drops every week for potentiating the effect of drops. Tensions in the eyes were recorded twice a week. The follow-up period was about six weeks.

b) Systemic and local steroid group: This comprised of six rabbits. In sub groups of two, rabbits were fed 5 mg, 7.5 mg and 10 mg of prednisolone in the form of suspension through a rubber tube in the oesophagus. In addition, hydrocortisone ointment was instilled twice daily in the right eye. The tension was recorded twice a week. The treatment and check up were continued for six weeks.


  Observations Top


The normal tension range in rabbits was found to be between 18 and 24 mm Hg with a mean of 21.08 mm Hg in the right eye and 20.81 mm Hg in the left eye.

The first group comprising of nine rabbits received local corticosteroids only in one eye and were followed for 39 to 45 days. None of the rabbits as depicted in [Table - 1] given below showed a rise of more than 1 mm Hg.

In the second group including six rabbits who received systemic prednisolone along with hydrocortisone ointment in the right eye were followed from 26 to 54 days. During this therapy, the rabbits lost weight and five of the six died probably due to general exhaustion. The mean final tension was 22.17 mm Hg in the right eye and 21.82 mm Hg in the left eye. No rabbit showed a rise of more than 1.2 mm Hg. The findings are well elucidated in [Table - 2] given below.

The graph in [Figure - 1] shows that during the first 20 days there was a fall in the mean intraocular pressure by 1 mm Hg., whereas during the next 22 days there was a rise by about 1.5 mm Hg. But the rise from the initial mean reading of 21 mm of Hg. was only by 0.5 mm Hg.


  Discussion And Conclusion Top


The above experimental study was undertaken to find out whether the use of corticosteroids over a prolonged period raised the intraocular pressure. Fifteen rabbits were taken and out of these 9 were subjected to its topical use for a mean period of 43 days. Along with it subconjunctival injections were given once a week. In the second group including 6 animals the drug was administered systemically for about 41.6 (average) days in a dosage ranging from -5 to 10 mg. of prednisolone. This dosage schedule is far higher than what is permisseable in human beings weight by weight. In the final analysis no significant rise in intra-ocular pressure or fall in the outflow facility was observed. These findings thus go in agreement with those of BECKER AND MILLS[3] but at the same time it is rather difficult to explain and reconcile with the finding observed by various workers (von SALLMANN, Pillat and Powers[10]; KOSAKI et al[6]; SHEVALEV[8]) who have actually seen the change in intra-ocular pressure when the animals were administered the drug systemically only.

To substantiate the above study further work is being undertaken clinically both on normal and glaucoma suspects and will be reported.


  Summary Top


The present investigation includes 6 rabbits receiving systemic prednisolone for a mean period of 41.6 days and nine rabbits receiving it topically in one eye for a mean period of 43 days. No. appreciable rise in intraocular pressure was found in any of the animals.

 
  References Top

1.
ARMALY, M. F. Effect of corticosteroids on intraocular Pressure and fluid dynamics. ii, effect of dexamethasone on glaucomatous eye. A.M.A. Arch. Ophth. (Chicago) 70: 492, (1963).  Back to cited text no. 1
    
2.
ARMALY, M. F. Effect of corticosteroids on intra ocular pressure and fluid dynamics. A.M.A. Arch. Ophth. (Chicago) 71: 636 (1964).  Back to cited text no. 2
    
3.
BECKER, B. AND MILLS, D. W.: Corticosteroids and intraocular pressure. A.M.A. Arch. Ophth. (Chicago) 70: 500, (1963).  Back to cited text no. 3
    
4.
BLACK, R. L. OGLESBY, R. B. von SALLMANN and L. BUNIM, J. J. Effect of steroids on Intraocular pressure J. Amer. Med. Assoc. 174: 166 (1960).  Back to cited text no. 4
    
5.
BLACK, , E. M., FASANELL, R. M., WONG, A. S. The effect of A.C.T.H. in glaucoma. Amer. J. Ophthal. 33: 1231, (1950).  Back to cited text no. 5
    
6.
KOSAKI, H. NAKATANI, AZUMA, I. Acta Soc. Ophthal. Jap 62: 1445, (1958). Taken from Ophthal. Literature 12: 2432 (1958).  Back to cited text no. 6
    
7.
LEE, P. The influence of systemic steroids therapy on the intraocular pressure. Amer. J. Ophth. 46: 328, (1958)  Back to cited text no. 7
    
8.
SALLMANN, L., von, PILLAT, B. AND POWERS, M. M.: Further studies on the influence of ACTH on the reactivity of terminal vascular bed in the eye. Amer. J. Ophth. 38: 655, (1954).  Back to cited text no. 8
    
9.
SHEVALEV, A. E. Voprosy eksperimentalnoi, dEentse falnoi glaukomy. Oftal Zh. 71: 479 (1962).  Back to cited text no. 9
    
10.
TILLET, C. W. Effect of A.C.T.H. on normal ocular tension. Amer. J, Ophth. 32: 659, (1952).  Back to cited text no. 10
    


    Figures

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    Tables

  [Table - 1], [Table - 2]



 

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