![]() The latter two studies were limited by their sample sizes, the use of multiple brands of topical corticosteroids, and differing applications of prescription strength or usage patterns. Ī retrospective study performed by Tamagawa-Mineoka et al on 65 patients demonstrated no association between topical periocular corticosteroid use and IOP, whereas a study performed by Maeng et al on 31 patients demonstrated a positive correlation only in patients with baseline IOPġ4 mm Hg. In a retrospective case control of 9793 patients, Garbe et al showed that nasal glucocorticoids were not associated with intraocular hypertension. ![]() While multiple case reports have described IOP elevation or glaucoma as a direct result of periocular corticosteroid use, larger studies remain inconclusive. In the eyelid, increased use of topical corticosteroids may be particularly problematic given their close proximity to the eye.ĭespite the growing body of literature that suggests that IOP can be elevated both in response to systemic and local corticosteroids, the effect of periocular steroids in particular is still relatively unknown. Steroid potency is thought to be correlated to their ocular hypertensive effect, while the duration of use has also been shown to increase ocular hypertension. Several mechanisms are thought to be responsible for this effect, including corticosteroids leading to an accumulation of polymerized glycosaminoglycans in the trabecular meshwork and increases in the trabecular meshwork's cell size and shape, leading to increased aqueous humor outflow resistance. Prolonged use of local (ocular surface, subconjunctival, sub-Tenon's, retrobulbar) and systemic corticosteroids is associated with a rise in intraocular pressure (IOP) and resultant glaucoma. It is expected that with increasing incidence of AD, including in the eyelid, the use of topical periocular corticosteroids will also increase over time. It affects up to 20% of children and 3% of adults worldwide and is most commonly treated with topical corticosteroids. Atopic dermatitis (AD) is a common, chronic relapsing inflammatory skin condition with increasing incidence in the past decades, especially in industrialized nations.
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