Risk factors predicting steroid-induced ocular hypertension after photorefractive keratectomy.

PURPOSE: To assess the risk factors contributing to steroid-induced ocular hypertension after photorefractive keratectomy (PRK). SETTING: Care Laser Centers, Tel Aviv, Israel. DESIGN: Retrospective case series. METHODS: Patients having PRK between January 2000 and December 2015 were followed for at least 3 months. Intraocular pressure (IOP) was measured using the Goldmann applanation tonometer after 1 week and after 1, 3, and 6 months. Ocular hypertension was defined as an IOP elevation of 25% while on topical steroid treatment (minimum 28 mm Hg) followed by an IOP drop of 25% when steroid treatment was discontinued. RESULTS: The study comprised 1783 patients (3566 eyes). The mean age of the patients was 26.95 years ± 7.56 (SD), and 54.85% were men. A total of 106 eyes (2.97%) were steroid responders. The responder group had a higher proportion of men than the nonresponder group (70.75% versus 29.25%; P < .001), higher central corneal thickness (CCT) (531.9 ± 40.2 µm versus 521.2 ± 40.9 µm; P = .008), lower mean keratometry (K) power (43.39 ± 1.84 diopters [D] versus 44.08 ± 1.88 D; P < .001), higher proportion of high myopia (>6.0 D) (31.13% versus 22.18%; P = .03), and higher rate of postoperative corneal haze (16.98% versus 4.25%; P < .001) and were treated postoperatively with more potent steroids. All factors remained significant in the multivariate analysis. CONCLUSION: Significant factors associated with post-PRK ocular hypertension were male sex, high CCT, a low mean K reading, high myopia, corneal haze, and treatment with stronger steroids such as dexamethasone.

Is Episcleritis Associated to Glaucoma?

OBJECTIVE: The aim of this study was to show possible connection between episcleritis and open-angle glaucoma. DESIGN: This was a retrospective study. MATERIALS AND METHODS: Data on 21 patients who suffered from episcleritis and had no previous attack of episcleritis or glaucoma were collected for a period of 8 years (from 2004 to 2011). RESULTS: Six of the 21 patients of the study group (28.6%) were diagnosed as suffering from glaucoma. Four patients had a diffuse conjunctival congestion, 1 had sectoral congestion, and for 1 patient there was no record of conjunctival congestion. Two of the 6 patients with episcleritis and glaucoma experienced recurrent episcleritis events during the follow-up period. CONCLUSIONS: This study suggests an association between episcleritis and open-angle glaucoma.

Bevacizumab for CRVO Associated CME: Effect of Timing and Frequency of Injections on Final Visual Outcome.

Purpose. Injection of anti-VEGF antibody into the vitreous body is a well-established treatment for ischemic central retinal vein occlusion (CRVO) associated macular edema. Various treatment regimens regarding the timing, number, and frequency of injections have been proposed. Methods. We reviewed the medical records of 68 patients treated by intravitreal bevacizumab (Avastin) injections for macular edema due to CRVO. We examined final visual acuity six months following the last injection in relation to injection policy (one primary injection followed by subsequent injections based on anatomical response versus a prescheduled protocol of one injection per month for the first 3 months) and in relation to the time lapsing from CRVO diagnosis to the first injection. Results. Mean visual acuity improved more for patients treated by a protocol of 3 prescheduled injections than for those treated with one primary injection. Improvement in mean visual acuity was greater for patients who received their first injection within the first month than those treated after 3 months (P < 0.01). Conclusion. A protocol of three prescheduled injections of bevacizumab, starting within one month of a CRVO event, was associated with better visual outcome compared to single injection and/or treatment starting more than 3 months following the time of diagnosis.