Corticosteroid-induced ocular hypertension in the treatment of aphakic or pseudophakic cystoid macular edema.

PURPOSE: To examine the relationship between corticosteroid-induced ocular hypertension and the reduction and/or resolution of chronic aphakic or pseudophakic cystoid macular edema (CME).

METHODS

The authors retrospectively reviewed 454 cases coded for CME between 1971 and 1991 and identified 21 patients with aphakic or pseudophakic CME greater than 6 months' duration who experienced a documented rise in intraocular pressure (IOP) on corticosteroid therapy. These patients were compared with similarly treated controls who did not experience a rise in IOP, and visual acuity and the biomicroscopic appearance of CME were examined.

RESULTS

Sixteen of 21 patients showed improved visual acuity and reduction and/or resolution of CME. In all five cases of treatment failure, there was evidence of vitreous attachment to anterior segment structures. This is statistically significant compared with controls, in which 4 of 14 patients with normal vitreous anatomy showed similar improvement (P = 0.00003).

CONCLUSION

This small retrospective series suggests that in the absence of vitreous traction, corticosteroid-induced ocular hypertension possibly leads to reduction and/or resolution of chronic aphakic or pseudophakic cystoid macular edema.